Heart Xenotransplantation: Historical Background, Experimental Progress, and Clinical Prospects

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• 作者：Raghav Murthy ; MBBS^a ; Pietro Bajona ; MD^a ; ^{pietro.bajona@utsouthwestern.edu" class="auth_mail" title="E-mail the corresponding author} ; Jay K. Bhama ; MD^b ; David K.C. Cooper ; MD ; PhD^c
• 关键词：CRP ; complement regulatory protein ; Gal ; galactose-α1 ; 3-galactose ; GTKO ; α1 ; 3-galactosyltransferase gene knockout ; NeuGc ; N-glycolylneuraminic acid ; NHP ; nonhuman primate ; TBM ; thrombomodulin
• 刊名：The Annals of Thoracic Surgery
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：101
• 期：4
• 页码：1605-1613
• 全文大小：973 K

文摘

If pig hearts could be transplanted successfully into patients with end-stage cardiac failure, the critical shortage of hearts from deceased human donors would be overcome. The several attempts at cardiac xenotransplantation carried out in the 20th century, usually with hearts from nonhuman primates (NHPs), are reviewed, as are the surgical techniques used in experimental heart transplantation in animals. For a number of reasons, the pig has been selected as the potential source of organs for clinical transplantation. The major pathobiological barriers that the pig presents, and progress in overcoming these barriers either by genetic engineering of the pig or by the administration of novel immunosuppressive agents, are described. Currently, non–life-supporting pig heterotopic heart transplantation in NHPs has extended to more than 2 years in 1 case, with life-supporting orthotopic heart transplantation of almost 2 months. Future approaches to resolve the remaining problems and the selection of patients for the initial clinical trials are briefly discussed.