Fishman Jay A, El Khoury Joseph, Kawai Tatsuo, Riella Leonardo V, Elias Nahel, Williams Winifred, Crisalli Kerry A, Hashimoto Dean, Bercovici Sivan, Lindner Martin, Noll Nicholas, Balasundaram Gayathri, Getchell Kristen, Low Susan, Scales Brittney, Chhangawala Sagar, Marett Amanda, Curtis Michael, Yeung Vincent
Transplant Infectious Disease and Compromised Host Program, Infectious Disease Division, Massachusetts General Hospital, Boston, Massachusetts, USA; MGH Transplant Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
MGH Transplant Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
Am J Transplant. 2025 Jun 24. doi: 10.1016/j.ajt.2025.06.016.
The success and safety of clinical xenotransplantation are determined by technical aspects of surgery, the nature and intensity of immunosuppression, xenograft function, and the ability to avoid immunologic, hematologic, infectious, and malignant complications. In clinical xenotransplantation from swine, infectious challenges relate to the potential spread of pig pathogens to immunosuppressed humans as well as manifestations of infections of the recipient from prior exposures to common human organisms. Robust strategies are required for donor screening, recipient monitoring, and infection prevention. This report outlines the comprehensive infectious disease management strategy deployed in the first living human recipient of a genetically modified pig kidney, including the following: (1) donor screening and pathogen mitigation, (2) pretransplant and posttransplant infection monitoring of the recipient, (3) infectious complications and management, and (4) implications for future xenotransplantation protocols.
临床异种移植的成功与安全性取决于手术的技术层面、免疫抑制的性质与强度、异种移植物的功能，以及避免免疫、血液、感染和恶性并发症的能力。在猪到人的临床异种移植中，感染挑战涉及猪病原体向免疫抑制的人类潜在传播，以及受者因先前接触常见人类病原体而出现的感染表现。需要强有力的策略进行供体筛查、受者监测和感染预防。本报告概述了首例接受基因编辑猪肾移植的活体人类受者所采用的全面传染病管理策略，包括以下内容：（1）供体筛查与病原体控制，（2）受者移植前和移植后的感染监测，（3）感染并发症及管理，以及（4）对未来异种移植方案的启示。
