Chair of Livestock Biotechnology, School of Life Sciences, Technical University of Munich, Munich, Germany.
Transgenic Res. 2022 Jun;31(3):391-398. doi: 10.1007/s11248-022-00306-w. Epub 2022 May 11.
To bridge the gap between organ demand and supply, xenotransplantation has long been considered as a realistic option for end-stage organ failure. Early this year this promise became reality for David Bennett Sr., the first patient whose own failing heart was replaced with a xeno-pig heart. To get here has been a rollercoaster ride of physiological hurdles seemingly impossible to overcome, technological breakthroughs and ethical and safety concerns. It started in 1984, with Stephanie Fae Beauclair, also known as baby Fae, receiving a baboon heart, which allowed her to survive for another 30 days. For ethical reasons primate work was soon abandoned in favour of the pig. But increased phylogenetic distance also brought with it an increased immunological incompatibility. It has been the development of ever more sophisticated genetic engineering tools, which brought down the physiological barriers, enabled humanisation of porcine organs and helped addressing safety concerns. This renewed the confidence in xenotransplantation, brought new funding opportunities and resulted finally in the first in human trial.
为了弥合器官需求和供应之间的差距，异种移植长期以来一直被视为治疗晚期器官衰竭的一种现实选择。今年年初，大卫·贝内特（David Bennett Sr.）成为第一个接受异种猪心脏移植的患者，他自身衰竭的心脏被异种猪心脏所取代，这一承诺终于成为现实。为了实现这一目标，人们克服了似乎无法逾越的生理障碍、技术突破以及伦理和安全问题。这一历程始于 1984 年，斯蒂芬妮·法·博克莱尔（Stephanie Fae Beauclair），也被称为婴儿法（Baby Fae），接受了一只狒狒心脏，这使她又存活了 30 天。出于伦理原因，灵长类动物的相关工作很快被放弃，转而使用猪。但随着进化距离的增加，也带来了更大的免疫相容性问题。正是越来越复杂的基因工程工具的发展，降低了生理障碍，实现了猪器官的人类化，并有助于解决安全问题。这重新激发了人们对异种移植的信心，带来了新的资金机会，最终导致了首例人体试验。
