Thomas E Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA.
Expert Rev Clin Immunol. 2010 Mar;6(2):219-30. doi: 10.1586/eci.09.81.
Cross-species transplantation (xenotransplantation) has immense potential to solve the critical need for organs, tissues and cells for clinical transplantation. The increasing availability of genetically engineered pigs is enabling progress to be made in pig-to-nonhuman primate experimental models. Potent pharmacologic immunosuppressive regimens have largely prevented T-cell rejection and a T-cell-dependent elicited antibody response. However, coagulation dysfunction between the pig and primate is proving to be a major problem, and this can result in life-threatening consumptive coagulopathy. This complication is unlikely to be overcome until pigs expressing a human 'antithrombotic' or 'anticoagulant' gene, such as thrombomodulin, tissue factor pathway inhibitor or CD39, become available. Progress in islet xenotransplantation has been more encouraging, and diabetes has been controlled in nonhuman primates for periods in excess of 6 months, although this has usually been achieved using immunosuppressive protocols that might not be clinically applicable. Further advances are required to overcome the remaining barriers.
异种移植（xenotransplantation）具有巨大的潜力，可以解决临床移植对器官、组织和细胞的迫切需求。基因工程猪的日益普及使得在猪到非人类灵长类动物实验模型方面取得了进展。有效的药物免疫抑制方案在很大程度上阻止了 T 细胞排斥和 T 细胞依赖性抗体应答。然而，猪和灵长类动物之间的凝血功能障碍被证明是一个主要问题，这可能导致危及生命的消耗性凝血障碍。在表达人“抗血栓”或“抗凝”基因（如血栓调节蛋白、组织因子途径抑制剂或 CD39）的猪出现之前，这种并发症不太可能得到解决。胰岛异种移植的进展更为鼓舞人心，已经有超过 6 个月的时间，非人类灵长类动物的糖尿病得到了控制，尽管这通常是使用免疫抑制方案实现的，而这些方案在临床上可能并不适用。需要进一步的进展来克服剩余的障碍。
