Cardiac Xenotransplantation: A Narrative Review.
| Autor: | Thuan PQ; Department of Adult Cardiovascular Surgery, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, 72714 Ho Chi Minh City, Vietnam., Dinh NH; Department of Adult Cardiovascular Surgery, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, 72714 Ho Chi Minh City, Vietnam.; Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, 72714 Ho Chi Minh City, Vietnam. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Reviews in cardiovascular medicine [Rev Cardiovasc Med] 2024 Jul 24; Vol. 25 (7), pp. 271. Date of Electronic Publication: 2024 Jul 24 (Print Publication: 2024). |
| DOI: | 10.31083/j.rcm2507271 |
| Abstrakt: | Cardiac xenotransplantation (cXT) has emerged as a solution to heart donor scarcity, prompting an exploration of its scientific, ethical, and regulatory facets. The review begins with genetic modifications enhancing pig hearts for human transplantation, navigating through immunological challenges, rejection mechanisms, and immune responses. Key areas include preclinical milestones, complement cascade roles, and genetic engineering to address hyperacute rejection. Physiological counterbalance systems, like human thrombomodulin and endothelial protein C receptor upregulation in porcine xenografts, highlight efforts for graft survival enhancement. Evaluating pig and baboon donors and challenges with non-human primates illuminates complexities in donor species selection. Ethical considerations, encompassing animal rights, welfare, and zoonotic disease risks, are critically examined in the cXT context. The review delves into immune control mechanisms with aggressive immunosuppression and clustered regularly interspaced palindromic repeats associated protein 9 (CRISPR/Cas9) technology, elucidating hyperacute rejection, complement activation, and antibody-mediated rejection intricacies. CRISPR/Cas9's role in creating pig endothelial cells expressing human inhibitor molecules is explored for rejection mitigation. Ethical and regulatory aspects emphasize the role of committees and international guidelines. A forward-looking perspective envisions precision medical genetics, artificial intelligence, and individualized heart cultivation within pigs as transformative elements in cXT's future is also explored. This comprehensive analysis offers insights for researchers, clinicians, and policymakers, addressing the current state, and future prospects of cXT. Competing Interests: The authors declare no conflict of interest. (Copyright: © 2024 The Author(s). Published by IMR Press.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|