Postrach Johannes, Bauer Andreas, Schmoeckel Michael, Reichart Bruno, Brenner Paolo
Department of Cardiac Surgery, Ludwig-Maximilians University Munich, Munich, Germany.
Methods Mol Biol. 2012;885:155-68. doi: 10.1007/978-1-61779-845-0_10.
Xenotransplantation is a potential solution for the worldwide persisting donor organ shortage. However, immunological and physiological barriers need to be overcome before the first clinical trials can be started. Nonhuman primates are considered the most suitable recipients in preclinical xenotransplantation models. Heterotopic abdominal cardiac xenotransplantation is a well-established nonworking heart model for immunological and biological studies on acute and delayed xenograft rejection and xenograft survival. Nevertheless, orthotopic life-supporting pig-to-baboon heart transplantation is the only accepted model for future cardiac xenotransplantation in humans so far. Survival times of 3 months in at least 60% of consecutive experiments have to be achieved and a minimum number of ten nonhuman primates have to survive for this period of time before clinical transplantation may be started. We recently introduced the heterotopic thoracic technique of pig-to-baboon heart transplantation. We believe that this technique combines the advantages of a working heart model with the safety of heterotopic transplantation. We describe the technical procedure of the three different pig-to-baboon models and give detailed information on perioperative care of the recipients.
异种移植是解决全球持续存在的供体器官短缺问题的一种潜在方法。然而，在开展首次临床试验之前，需要克服免疫和生理障碍。非人灵长类动物被认为是临床前异种移植模型中最合适的受体。异位腹部心脏异种移植是一种成熟的非功能性心脏模型，用于急性和延迟性异种移植排斥反应及异种移植存活的免疫和生物学研究。尽管如此，原位支持生命的猪到狒狒心脏移植是迄今为止人类未来心脏异种移植唯一被认可的模型。在开始临床移植之前，必须在至少60%的连续实验中实现3个月的存活时间，并且在此期间至少有10只非人灵长类动物存活。我们最近引入了猪到狒狒心脏移植的异位胸腔技术。我们认为该技术结合了功能性心脏模型的优点和异位移植的安全性。我们描述了三种不同猪到狒狒模型的技术操作，并提供了受体围手术期护理的详细信息。
