The need for xenotransplantation as a source of organs and cells for clinical transplantation.
The need for xenotransplantation as a source of organs and cells for clinical transplantation.
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DOI：
10.1016/j.ijsu.2015.06.066
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发表时间：
2015-11
期刊：
影响因子：
--
通讯作者：
Tector AJ
中科院分区：
文献类型：
--
作者：
Ekser B;Cooper DKC;Tector AJ
用于临床移植目的的死亡人体器官和细胞的有限供应在全世界仍然至关重要。尽管越来越多地使用“高风险”，“边缘”或“扩展标准”的已故捐赠者，但在美国，每天有30名患者死亡或因病情过重而无法接受器官移植而被从等待名单中删除。在某些其他国家，对死者捐赠存在文化阻力，例如，在日本，增加利用活体供体，例如，一个肾脏或部分肝脏，只能部分解决器官短缺的问题。对于组织和细胞的移植，例如，糖尿病患者的胰岛移植和角膜盲患者的角膜移植（全世界角膜盲患者的数量可能有数百万），同种异体移植永远不会证明是一个足够的来源。迫切需要器官和细胞的替代来源。猪可以证明是一个令人满意的来源，使用猪器官或细胞的临床异种移植，特别是利用基因工程提供的抵抗人类免疫反应的优势，可以解决器官短缺问题。本文简要介绍了猪与人的生理相容性和不相容性。
The limited availability of deceased human organs and cells for the purposes of clinical transplantation remains critical worldwide. Despite the increasing utilization of ‘high-risk’, ‘marginal’, or ‘extended criteria’ deceased donors, in the U.S. each day 30 patients either die or are removed from the waiting list because they become too sick to undergo organ transplantation. In certain other countries, where there is cultural resistance to deceased donation, e.g., Japan, the increased utilization of living donors, e.g., of a single kidney or partial liver, only very partially addresses the organ shortage. For transplants of tissues and cells, e.g., pancreatic islet transplantation for patients with diabetes, and corneal transplantation for patients with corneal blindness (whose numbers worldwide are potentially in the millions), allotransplantation will never prove a sufficient source. There is an urgent need for an alternative source of organs and cells. The pig could prove to be a satisfactory source, and clinical xenotransplantation using pig organs or cells, particularly with the advantages provided by genetic engineering to provide resistance to the human immune response, may resolve the organ shortage. The physiologic compatibilities and incompatibilities of the pig and the human are briefly reviewed.