McGregor, CGA;
Byrne, GW;
(2017)
Porcine to Human Heart Transplantation: Is Clinical Application Now Appropriate?
Journal of Immunology Research
, 2017
, Article 2534653. 10.1155/2017/2534653.
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Abstract
Cardiac xenotransplantation (CXTx) is a promising solution to the chronic shortage of donor hearts. Recent advancements in immune suppression have greatly improved the survival of heterotopic CXTx, now extended beyond 2 years, and life-supporting kidney XTx. Advances in donor genetic modification (B4GALNT2 and CMAH mutations) with proven Gal-deficient donors expressing human complement regulatory protein(s) have also accelerated, reducing donor pig organ antigenicity. These advances can now be combined and tested in life-supporting orthotopic preclinical studies in nonhuman primates and immunologically appropriate models confirming their efficacy and safety for a clinical CXTx program. Preclinical studies should also allow for organ rejection to develop xenospecific assays and therapies to reverse rejection. The complexity of future clinical CXTx presents a substantial and unique set of regulatory challenges which must be addressed to avoid delay; however, dependent on these prospective life-supporting preclinical studies in NHPs, it appears that the scientific path forward is well defined and the era of clinical CXTx is approaching.
| Type: | Article |
|---|---|
| Title: | Porcine to Human Heart Transplantation: Is Clinical Application Now Appropriate? |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1155/2017/2534653 |
| Publisher version: | http://doi.org/10.1155/2017/2534653 |
| Language: | English |
| Additional information: | Copyright © 2017 Christopher G. A. McGregor and Guerard W. Byrne. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Immunology, CARDIAC XENOGRAFT SURVIVAL, N-GLYCOLYLNEURAMINIC ACID, TO-PRIMATE XENOTRANSPLANTATION, ENDOGENOUS RETROVIRUSES PERVS, GENETICALLY-ENGINEERED PIGS, ACUTE VASCULAR REJECTION, NATURAL-KILLER-CELLS, CD46 TRANSGENIC PIG, GENE-KNOCKOUT PIGS, HYPERACUTE REJECTION |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Pre-clinical and Fundamental Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10039582 |
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