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心脏异种移植

Heart xenotransplantation.

作者信息

Chan Joshua L, Mohiuddin Muhammad M

机构信息

Cardiothoracic Surgery Research Program, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.

出版信息

Curr Opin Organ Transplant. 2017 Dec;22(6):549-554. doi: 10.1097/MOT.0000000000000461.

Abstract

PURPOSE OF REVIEW

Cardiac xenotransplantation has entered an exciting era, marked by numerous considerable advances in the field, and continues to be of great interest because of its potential ability in ameliorating the current constraints of limited allograft availability. This review aims to examine recent progress in this rapidly changing discipline.

RECENT FINDINGS

Although several hurdles remain, the use of rapidly evolving transgenic technology, in combination with novel immunosuppression regimens, has the potential to address current allogenic donor pool constraints and mechanical circulatory system device limitations. Furthermore, innovative uses of biomarker tools, such as miRNA, serve as a method for improved monitoring of xenograft status. These tools may allow for more targeted immunosuppressive strategies as well as earlier interventions to mitigate xenograft rejection. Finally, coinciding with these remarkable advances, preliminary consideration of the clinical application for cardiac xenotransplantation has begun, particularly regarding specific patient criteria for these initial clinical trials.

SUMMARY

The studies in this review highlight efforts in multiple disciplines to optimize perioperative and postxenotransplant outcomes. In examining these individual topics, this article reflects the exciting and ongoing progress in the field of cardiac xenotransplantation.

摘要

综述目的

心脏异种移植已进入一个令人兴奋的时代,该领域取得了众多重大进展,并且由于其在缓解当前同种异体移植物供应受限方面的潜在能力,仍然备受关注。本综述旨在探讨这一快速发展学科的最新进展。

最新发现

尽管仍存在一些障碍,但结合新型免疫抑制方案使用快速发展的转基因技术,有可能解决当前同种异体供体库的限制和机械循环系统装置的局限性。此外,生物标志物工具(如miRNA)的创新应用,可作为改善异种移植状态监测的一种方法。这些工具可能有助于制定更具针对性的免疫抑制策略,并进行更早的干预以减轻异种移植排斥反应。最后,与这些显著进展同时发生的是,心脏异种移植临床应用的初步考虑已经开始,特别是关于这些初始临床试验的特定患者标准。

总结

本综述中的研究突出了多个学科为优化围手术期和异种移植后结果所做的努力。在审视这些个别主题时,本文反映了心脏异种移植领域令人兴奋且持续不断的进展。

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