Pig heart and lung xenotransplantation: Present status.
clinical
heart
lung
nonhuman primate
pig
xenotransplantation
Journal
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
ISSN: 1557-3117
Titre abrégé: J Heart Lung Transplant
Pays: United States
ID NLM: 9102703
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
15
03
2022
revised:
14
04
2022
accepted:
24
04
2022
pubmed:
7
6
2022
medline:
28
7
2022
entrez:
6
6
2022
Statut:
ppublish
Résumé
The recent pig heart transplant in a patient at the University of Maryland Medical Center has stimulated renewed interest in the xenotransplantation of organs from genetically engineered pigs. The barriers to the use of pigs as sources of organs have largely been overcome by 2 approaches - (1) the deletion of expression of the three known pig carbohydrate xenoantigens against which humans have preformed antibodies, and (2) the transgenic introduction of human 'protective' proteins, such as complement-regulatory proteins. These gene modifications, coupled with immunosuppressive therapy based on blockade of the CD40/CD154 costimulation pathway, have resulted in survival of baboons with life-supporting pig heart grafts for almost 9 months. The initial clinical success at the University of Maryland reinforces encouraging preclinical results. It suggests that pig hearts are likely to provide an effective bridge to an allotransplant, but their utility for destination therapy remains uncertain. Because of additional complex immunobiological problems, the same approach has been less successful in preclinical lung xenograft transplantation, where survival is still measured in days or weeks. The first formal clinical trials of pig heart transplantation may include patients who do not have access to an allotransplant, those with contraindications for mechanical circulatory support, those in need of retransplantation or with a high level of panel-reactive antibodies. Infants with complex congenital heart disease, should also be considered.
Identifiants
pubmed: 35659792
pii: S1053-2498(22)01914-3
doi: 10.1016/j.healun.2022.04.010
pmc: PMC10124776
mid: NIHMS1886986
pii:
doi:
Substances chimiques
Immunosuppressive Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
1014-1022Subventions
Organisme : NIAID NIH HHS
ID : R01 AI153612
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI153612
Pays : United States
Organisme : NIAID NIH HHS
ID : U19 AI090959
Pays : United States
Informations de copyright
Copyright © 2022 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest statement DC is a consultant to eGenesis Bio, Cambridge, MA, USA. No other author declares a conflict of interest.
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