Progress toward Pig-to-Human Xenotransplantation.
Progress toward Pig-to-Human Xenotransplantation.
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DOI：
10.1056/nejmp2118019
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发表时间：
2022-05-19
影响因子：
158.5
通讯作者：
Pierson, Richard N., III
中科院分区：
文献类型：
--
作者：
Pierson, Richard N., III
最近宣布，转基因猪肾在附着到三个脑死亡的人的循环中后存活了2天多--其中两个在纽约大学（NYU;见蒙哥马利等人，第1889-98页）和一个在伯明翰的亚拉巴马大学（UAB）1-以及一个在马里兰州大学（UMD）进行的维持生命的猪到人心脏移植已经成为头条新闻。评论家们宣称这些进步是“一个巨大的突破”和“一个分水岭时刻”。事实上，异种移植带来了无限供应现成的、安全的、功能最佳的器官的希望。尽管非人类灵长类动物的器官在肾脏、肝脏和心脏移植的人类受体中表现出了生命支持功能，但在20世纪90年代，人们担心内源性逆转录病毒可能会导致人类的传染性感染，导致美国和许多其他国家暂停了此类移植。黑猩猩（最具生物相容性和大小合适的潜在来源动物）的供应非常有限，创造可证明“安全”的灵长类动物供体的物流障碍，以及大量的伦理问题将该领域引向驯化物种。
The recent announcements that genetically modified pig kidneys survived for more than 2 days after being attached to the circulation of three brain-dead humans—two at New York University (NYU; see Montgomery et al., pages 1889–98) and one at the University of Alabama at Birmingham (UAB) 1—and that a life-supporting pig-to-human heart transplantation was performed at the University of Maryland (UMD) have made headlines. Commentators have pronounced these advances “a huge breakthrough” and “a watershed moment.” And indeed, xenotransplantation carries the promise of an unlimited supply of readily available, safe, optimally functioning organs. Although organs from nonhuman primates have exhibited life-supporting function in human recipients of kidney, liver, and heart transplants, in the 1990s concern that endogenous retroviruses might cause contagious infection in humans led to a moratorium on such transplantations in the United States and many other countries. The very limited supply of chimpanzees (the most biologically compatible and size-appropriate potential source animal), logistic barriers to creating certifiably “safe” primate donors, and substantial ethical concerns steered the field toward domesticated species.