1. Pathways to Clinical Cardiac Xenotransplantation.
- Author
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Reichart B, Längin M, Denner J, Schwinzer R, Cowan PJ, and Wolf E
- Subjects
- Animals, Animals, Genetically Modified, Graft Rejection immunology, Graft Rejection prevention & control, Graft Survival, Heart Failure diagnosis, Heart Failure physiopathology, Humans, Postoperative Complications etiology, Recovery of Function, Risk Assessment, Risk Factors, Sus scrofa genetics, Transplantation, Heterologous, Treatment Outcome, Waiting Lists, Heart Failure surgery, Heart Transplantation adverse effects, Tissue Donors supply & distribution
- Abstract
Heart transplantation is the only long-lasting lifesaving option for patients with terminal cardiac failure. The number of available human organs is however far below the actual need, resulting in substantial mortality of patients while waiting for a human heart. Mechanical assist devices are used to support cardiac function but are associated with a high risk of severe complications and poor quality of life for the patients. Consistent success in orthotopic transplantation of genetically modified pig hearts into baboons indicates that cardiac xenotransplantation may become a clinically applicable option for heart failure patients who cannot get a human heart transplant. In this overview, we project potential paths to clinical cardiac xenotransplantation, including the choice of genetically modified source pigs; associated requirements of microbiological, including virological, safety; optimized matching of source pig and recipient; and specific treatments of the donor heart after explantation and of the recipients. Moreover, selection of patients and the regulatory framework will be discussed., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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