The immunological problems of pig hearts supporting life in human recipients have potentially been solved
by transgenic technology. Nevertheless, other problems still remain. Autonomic innervation is important for
the control of cardiac dynamics and there is evidence suggesting that some neurons remain intact after
transplantation. Previous studies in the human heart have established regional differences in both general
autonomic innervation and in its component neural subpopulations. Such studies are lacking in the pig
heart. Quantitative immunohistochemical and histochemical techniques were used to demonstrate the pattern
of innervation in pig hearts (Sus scrofa). Gradients of immunoreactivity for the general neural marker
protein gene product 9.5 were observed both within and between the endocardial, myocardial and epicardial
plexuses throughout the 4 cardiac chambers. An extensive ganglionated plexus was observed in the
epicardial tissues and, to a lesser extent, in the myocardial tissues. The predominant neural subpopulation
displayed acetylcholinesterase activity, throughout the endocardium, myocardium and epicardium. These
nerves showed a right to left gradient in density in the endocardial plexus, which was not observed in either
the myocardial or epicardial plexuses. A large proportion of nerves in the ganglionated plexus of the atrial
epicardial tissues displayed AChE activity, together with their cell bodies. Tyrosine hydroxylase (TH)-immunoreactive nerves were the next most prominent subpopulation throughout the heart. TH-immunoreactive cell bodies were observed in the atrial ganglionated plexuses. Endocardial TH- and NPY-immunoreactive nerves also displayed a right to left gradient in density, whereas in the epicardial tissues
they showed a ventricular to atrial gradient. Calcitonin gene-related peptide (CGRP)-immunoreactive nerves
were the most abundant peptide-containing subpopulation after those possessing NPY immunoreactivity.
They were most abundant in the epicardial tissues of the ventricles. Several important differences were
observed between the innervation of the pig heart compared with the human heart. These differences may
have implications for the function of donor transgenic pig hearts within human recipients.