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.
Original language | English (US) |
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Article number | 2534653 |
Journal | Journal of Immunology Research |
Volume | 2017 |
DOIs | |
State | Published - 2017 |
Externally published | Yes |
Bibliographical note
Funding Information:This study is supported by the NIH Grant AI66310, the MRC Grant MR L013193, and the NIHR UCL Biomedical Research Centre.
Publisher Copyright:
© 2017 Christopher G. A. McGregor and Guerard W. Byrne.