Byrne Guerard W, McGregor Christopher G A
Department of Surgery, Experimental Surgical Services, University of Minnesota, Minneapolis, MN, United States.
Institute of Cardiovascular Sciences, University College London, London, United Kingdom.
Front Transplant. 2025 Apr 15;4:1568910. doi: 10.3389/frtra.2025.1568910. eCollection 2025.
Xenotransplantation offers an opportunity to radically change the availability of organs for life-saving human transplantation. Great progress has been made in porcine donor genetic engineering to reduce the immunogenicity of pig organs and potentially enhance their resistance to antibody-mediated rejection. There is also growing insight into more effective immune suppression regimens. These advances have improved the duration of cardiac xenograft survival in non-human primates over the last decade and supported the recent approval of the first-in-human clinical use of pig hearts and kidneys for transplantation. This review critically examines preclinical and clinical results in cardiac xenotransplantation. We identify challenges that remain to achieve consistent and durable clinical graft survival. We discuss the relative value of preclinical non-human primate and human decedent transplant models to optimize patient cross-matching, immune suppression, postoperative monitoring, and graft survival.
异种移植为从根本上改变用于挽救人类生命的移植器官的可获得性提供了机会。在猪供体基因工程方面已经取得了巨大进展，以降低猪器官的免疫原性，并有可能增强其对抗体介导的排斥反应的抵抗力。人们对更有效的免疫抑制方案也有了越来越深入的了解。在过去十年中，这些进展提高了心脏异种移植物在非人灵长类动物中的存活时间，并支持了最近猪心脏和肾脏首次用于人类临床移植的批准。本综述批判性地审视了心脏异种移植的临床前和临床结果。我们确定了实现持续且持久的临床移植物存活仍面临的挑战。我们讨论了临床前非人灵长类动物和人类尸体移植模型在优化患者交叉配型、免疫抑制、术后监测和移植物存活方面的相对价值。
