The resurgent landscape of xenotransplantation of pig organs in nonhuman primates
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e resurgent landscape of xenotransplantation of pig organs in nonhuman primates 1†
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Xuan Zhang , Quancheng Wang , Jingjun Zhao , Xiao Li , Wei Peng , Zhaoxu Yang , 1 1 1 1* 1* Zhibin Lin , Long Yang , Rui Ding , Kaishan Tao & Kefeng Dou 1
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Department of Hepatobiliary Surgery, Xijing Hospital, The Fourth Military Medical University, Xi’an 710032, China; Institute of Nutrition and Food Safety, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an 710054, China Received July 21, 2020; accepted August 27, 2020; published online September 21, 2020
Organ shortage is a major bottleneck in allotransplantation and causes many wait-listed patients to die or become too sick for transplantation. Genetically engineered pigs have been discussed as a potential alternative to allogeneic donor organs. Although xenotransplantation of pig-derived organs in nonhuman primates (NHPs) has shown sequential advances in recent years, there are still underlying problems that need to be completely addressed before clinical applications, including (i) acute humoral xenograft rejection; (ii) acute cellular rejection; (iii) dysregulation of coagulation and inflammation; (iv) physiological incompatibility; and (v) cross-species infection. Moreover, various genetic modifications to the pig donor need to be fully characterized, with the aim of identifying the ideal transgene combination for upcoming clinical trials. In addition, suitable pretransplant screening methods need to be confirmed for optimal donor-recipient matching, ensuring a good outcome from xenotransplantation. Herein, we summarize the understanding of organ xenotransplantation in pigs-to-NHPs and highlight the current status and recent progress in extending the survival time of pig xenografts and recipients. We also discuss practical strategies for overcoming the obstacles to xenotransplantation mentioned above to further advance transplantation of pig organs in the clinic. organ, xenotransplantation, pig, non-human primate, genetical engineering Citation:
Zhang, X., Wang, Q., Zhao, J., Li, X., Peng, W., Yang, Z., Lin, Z., Yang, L., Ding, R., Tao, K., et al. (2020). The resurgent landscape of xenotransplantation of pig organs in nonhuman primates. Sci China Life Sci 63, https://doi.org/10.1007/s11427-019-1806-2
Introduction Currently, for patients with terminal organ failure, transplantation is the most practical and effective life-saving method worldwide, and recipients show less morbidity and a superior quality of life. However, many wait-listed patients die or become too sick for transplantation due to the lack of suitable donor organs. According to the latest literature (Wang et al., 2019), over 300,000 patients are on the waiting list in China, but only approximately 10,000 of them can †Contributed equally to this work *Corresponding authors (Kaishan Tao, email: [email protected]; Kefeng Dou, email: [email protected])
receive organ transplantation annually, thus highlighting the urgent need to expand the number of available donor organs
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