Heart xenotransplantation

Chan, Joshua L.; Mohiuddin, Muhammad M.

doi:10.1097/mot.0000000000000461

Cited by 13 publications

(9 citation statements)

References 24 publications

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“…This therapy will be expensive. All transplantation is associated with immunosuppression costs, but additional expensive novel immunotherapy may be required for xenotransplantation 29 . Competition among the companies involved in creating these organs might keep the costs in check, but this seems not to have happened with many medical therapies.…”

Section: Efficacy Access and Expense—short And Long Termmentioning

confidence: 99%

Clinical xenotransplantation seems close: Ethical issues persist

2022

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Scientific barriers that have prevented successful xenotransplantation are being breached, yet many ethical issues remain. Some are broad issues that accompany the adoption of novel and expensive technologies, and some are unique to xenotransplantation. Major ethical questions include areas such as: viral transmission; zoonoses and lifetime surveillance; interfering with nature; efficacy, access, and expense; treatment of animals; regulation and oversight.

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Section: Efficacy Access and Expense—short And Long Termmentioning

confidence: 99%

Clinical xenotransplantation seems close: Ethical issues persist

2022

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“…Through a combination of many discoveries in enhanced immunosuppression and genetic engineering as well as a better understanding of cross-species incompatibilities, the field of xenotransplantation has made significant progress in the last decade. As a result, cardiac xenograft survival has been demonstrated for more than three years [57]. With the correct immunosuppressive regimen, xenograft survival can be extended.…”

Section: Future Of Xenotransplantationmentioning

confidence: 99%

Evolution of Xenotransplantation as an Alternative to Shortage of Donors in Heart Transplantation

Wadiwala¹,

Garg²,

Yazji³

et al. 2022

Cureus

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This review aims to show and illustrate the history, current, ethical considerations, and limitations concerning xenotransplantation. Due to the current shortage of available donor organs for transplantation, many alternative sources are being examined to solve the donor shortage. One of them is xenotransplantation which refers to the transplantation of organs from one species to another. Compared to other nonhuman primates (NHP), pigs are ideal species for organ harvesting as they rapidly grow to human size in a handful of months. There is much advancement in the genetic engineering of pigs, which have hearts structurally and functionally similar to the human heart. The role of genetic engineering is to overcome the immune barriers in xenotransplantation and can be used in hyperacute rejection and T cellmediated rejection. It is technically difficult to use large animal models for orthotopic, life-sustaining heart transplantation. Despite the fact that some religious traditions, such as Jewish and Muslim, prohibit the ingestion of pork products, few religious leaders consider that donating porcine organs is ethical because it saves human life. Although recent technologies have lowered the risk of a xenograft producing a novel virus that causes an epidemic, the risk still exists. It has major implications for the informed consent procedure connected with clinical research on heart xenotransplantation.

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“…For the long-term survival of other xenografts including heart, kidney, and islet cells, treatment with costimulation blockade agents is also crucial for maintenance therapy in most pig-to-NHP transplantation experiments ( Chan and Mohiuddin, 2017 ; Cooper et al, 2018 ; Higginbotham et al, 2015 ; Liu et al, 2017 ; Wijkstrom et al, 2017 ). Only two studies showed long-term survival of neonatal or embryonic islet xenotransplants with CD40/CD154 pathway-sparing regimens using rituximab, anti-thymocyte globulin (ATG), and belatacept as induction regimens; and abatacept, everolimus, and FTY720 as maintenance therapy ( Hecht et al, 2009 ; Thompson et al, 2012 ).…”

Section: Immunomodulating Agents In Xenotransplantationmentioning

confidence: 99%

Corneal xenotransplantation: Where are we standing?

Yoon¹,

Choi²,

Kim

2021

Progress in Retinal and Eye Research

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The search for alternatives to allotransplants is driven by the shortage of corneal donors and is demanding because of the limitations of the alternatives. Indeed, current progress in genetically engineered (GE) pigs, the introduction of gene-editing technology by clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9, and advanced immunosuppressants have made xenotransplantation a possible option for a human trial. Porcine corneal xenotransplantation is considered applicable because the eye is regarded as an immune-privileged site. Furthermore, recent non-human primate studies have shown long-term survival of porcine xenotransplants in keratoplasty. Herein, corneal immune privilege is briefly introduced, and xenogeneic reactions are compared with allogeneic reactions in corneal transplantation. This review describes the current knowledge on special issues of xenotransplantation, xenogeneic rejection mechanisms, current immunosuppressive regimens of corneal xenotransplantation, preclinical efficacy and safety data of corneal xenotransplantation, and updates of the regulatory framework to conduct a clinical trial on corneal xenotransplantation. We also discuss barriers that might prevent xenotransplantation from becoming common practice, such as ethical dilemmas, public concerns on xenotransplantation, and the possible risk of xenozoonosis. Given that the legal definition of decellularized porcine cornea (DPC) lies somewhere between a medical device and a xenotransplant, the preclinical efficacy and clinical trial data using DPC are included. The review finally provides perspectives on the current standpoint of corneal xenotransplantation in the fields of regenerative medicine.

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Heart xenotransplantation

Abstract: The studies in this review highlight efforts in multiple disciplines to optimize perioperative and postxenotransplant outcomes. In examining these individual topics, this article reflects the exciting and ongoing progress in the field of cardiac xenotransplantation.

Cited by 13 publications

References 24 publications

Clinical xenotransplantation seems close: Ethical issues persist

Clinical xenotransplantation seems close: Ethical issues persist

Evolution of Xenotransplantation as an Alternative to Shortage of Donors in Heart Transplantation

Corneal xenotransplantation: Where are we standing?

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