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基因编辑猪到人的心脏异种移植的现状与展望

Current status and prospects of genetically modified porcine-to-human cardiac xenotransplantation.

作者信息

Kawamura Takuji, Saito Shunsuke, Taguchi Takura, Yoshioka Daisuke, Kawamura Ai, Misumi Yusuke, Yamauchi Takashi, Miyagawa Shuji, Miyagawa Shigeru

机构信息

Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-Oka, Suita, Osaka, 565-0871, Japan.

Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-Oka, Suita, Osaka, 565-0871, Japan.

出版信息

J Artif Organs. 2025 May 4. doi: 10.1007/s10047-025-01504-z.

Abstract

Cardiac xenotransplantation utilizing genetically modified pigs presents a promising avenue for treating end-stage heart failure, a leading cause of mortality worldwide. This paper delineates the current landscape of heart failure treatment in Japan, emphasizing the limitations of existing therapies such as heart transplantation and implantable left ventricular assist devices. It discusses the history and advancements in the development of genetically modified pigs for xenotransplantation, highlighting recent breakthroughs and challenges. The manuscript also addresses the specific challenges facing the implementation of xenotransplantation in Japan, including the selection of suitable genetically modified pigs, ensuring organ safety, patient selection criteria, transplantation protocols, and immunosuppression strategies. Drawing from international experiences and ongoing research efforts, the paper emphasizes the potential of xenotransplantation while acknowledging the hurdles that must be overcome for widespread clinical adoption.

摘要

利用基因编辑猪进行心脏异种移植为治疗终末期心力衰竭提供了一条有前景的途径,终末期心力衰竭是全球主要的死亡原因之一。本文阐述了日本心力衰竭治疗的现状,强调了现有疗法如心脏移植和植入式左心室辅助装置的局限性。它讨论了用于异种移植的基因编辑猪的发展历史和进展,突出了近期的突破和挑战。该手稿还探讨了在日本实施异种移植所面临的具体挑战,包括合适的基因编辑猪的选择、确保器官安全性、患者选择标准、移植方案和免疫抑制策略。借鉴国际经验和正在进行的研究工作,本文在承认广泛临床应用必须克服的障碍的同时,强调了异种移植的潜力。

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