Recent progress and remaining hurdles toward clinical xenotransplantation.

摘要: BACKGROUND Xenotransplantation has made tremendous progress over the last decade. METHODS We discuss kidney and heart xenotransplantation, which are nearing initial clinical trials. RESULTS Life sustaining genetically modified xenografts can now for approximately 500 days orthotopic 200 days in non-human primates. Anti-swine specific antibody screening, preemptive desensitization protocols, complement inhibition targeted immunosuppression currently being adapted to xenotransplantation with hope achieve better control of antibody-mediated rejection (AMR) improve xenograft longevity. These newest advances could probably facilitate future trials, a significant step medical community, given that dialysis remains difficult many patients have prohibitive costs. Performing successful pig-to-human xenograft, more than year after transplant, seems feasible but it still potential hurdles overcome. The risk/benefit balance is progressively reaching an acceptable equilibrium human recipients, e.g. those life expectancy inferior two years. ultimate question at this stage would be determine if "proof concept" humans desirable, or whether further experimental/pre-clinical needed demonstrate longer survival CONCLUSION In review, we most recent focus on prevention treatment AMR recipient's selection, aspects will likely major points discussion first pig organ