Department of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation (VCA) Laboratory, Johns Hopkins University School of Medicine.
Department of General Surgery, University of Maryland Medical Center, Baltimore, Maryland, USA.
Curr Opin Organ Transplant. 2020 Oct;25(5):464-476. doi: 10.1097/MOT.0000000000000798.
To summarize the evolution of skin xenotransplantation and contextualize technological advances and the status of clinically applicable large animal research as well as prospects for translation of this work as a viable future treatment option.
Porcine xenografts at the start of the millennium were merely biologic dressings subject to rapid rejection. Since then, numerous important advances in swine to nonhuman primate models have yielded xenotransplant products at the point of clinical translation. Critical genetic modifications in swine from a designated pathogen-free donor herd have allowed xenograft survival reaching 30 days without preconditioning or maintenance immunosuppression. Further, xenograft coverage appears not to sensitize the recipient to subsequent allograft placement and vice versa, allowing for temporary coverage times to be doubled using both xeno and allografts.
Studies in large animal models have led to significant progress in the creation of living, functional skin xenotransplants with clinically relevant shelf-lives to improve the management of patients with extensive burns.
总结皮肤异种移植的发展历程，阐述技术进步以及临床适用的大动物研究现状，并展望将这项工作转化为可行的未来治疗选择的前景。
千禧年初的猪异种移植物仅仅是生物敷料，容易快速排斥。从那时起，猪到非人类灵长类动物模型的许多重要进展已经产生了处于临床转化阶段的异种移植物产品。来自无特定病原体供体畜群的猪的关键遗传修饰允许异种移植物在没有预处理或维持免疫抑制的情况下存活 30 天。此外，异种移植物覆盖似乎不会使受者对随后的同种异体移植放置敏感，反之亦然，这使得使用异种和同种异体移植物可以将临时覆盖时间延长一倍。
大动物模型的研究已经在创造具有临床相关保质期的活体功能性皮肤异种移植物方面取得了重大进展，这可以改善大面积烧伤患者的管理。
