Chapter 27

Xenotransplantion: Perspectives on the Future

Burcin Ekser

Abstract

Xenotransplantation using pig organs as source for transplant has the potential to overcome the severe shortage of human donor organs. Wide utilization of genetically-engineered pigs is enabling progress to be made in pig-to-nonhuman primate experimental models. Novel, non-nephrotoxic immunosuppressive regimens have largely overcome T cell rejection and a T cell-dependent elicited antibody response. Recent advances in understanding of the biology of xenograft rejection and zoonotic infections and the generation of alpha1,3-galactosyltransferase-gene knockout pigs have moved this approach closer to the clinical application. However, inter-species coagulation dysregulation is proving a major hurdle. Progress in islet xenotransplantation has been more encouraging controlling diabetes in nonhuman primates up to 6 months, though this has usually been achieved using immunosuppressive protocols that might not be clinically applicable. Further advances are required to overcome the remaining barriers.

Total Pages: 378-389 (12)

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