Schmoeckel Michael, Längin Matthias, Reichart Bruno, Abicht Jan-Michael, Bender Martin, Denner Joachim, Marckmann Georg, Brenner Paolo, Wolf Eckhard, Hagl Christian
Herzchirurgische Klinik und Poliklinik, LMU Klinikum - Standort Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
Klinik für Anästhesiologie, LMU Klinikum Großhadern, München, Deutschland.
Chirurgie (Heidelb). 2024 Aug;95(8):603-609. doi: 10.1007/s00104-024-02093-y. Epub 2024 May 15.
Transplantation of genetically modified porcine hearts and kidneys could become a solution to the persistent shortage of human organ donors. Progress has been made in genetic engineering of donor pigs, preservation techniques after organ harvesting and immunosuppression using co-stimulation blockade with anti-CD40/CD40L monoclonal antibodies. Progress has also been made in in the development of methods that detect pathogenic porcine viruses and prevent their transmission to the recipient. As normal land breed pig organs continue to grow in the recipient to their original size, different pig breeds (such as Auckland Island pigs) are now used which reach a final size suitable for humans. Alternatively, a knock-out of the growth hormone receptor gene has been established, e.g., in the 10GM genetically modified pigs from Revivicor/United Therapeutics, USA. The first clinical pilot studies including patients suffering from terminal heart failure are expected to start in Germany in about 2 years.
转基因猪心脏和肾脏的移植可能成为解决人体器官供体持续短缺问题的一种方法。在供体猪的基因工程、器官摘取后的保存技术以及使用抗CD40/CD40L单克隆抗体进行共刺激阻断的免疫抑制方面都取得了进展。在检测致病性猪病毒并防止其传播给受体的方法开发上也取得了进展。由于普通陆地品种猪的器官在受体中会持续生长到其原始大小,现在使用了不同的猪品种(如奥克兰岛猪),其最终大小适合人类。或者,已经建立了生长激素受体基因敲除技术,例如在美国Revivicor/联合治疗公司的10GM转基因猪中。预计包括晚期心力衰竭患者在内的首批临床试验将于大约两年内在德国启动。