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Review
. 2022 Mar 23:35:10171.
doi: 10.3389/ti.2022.10171. eCollection 2022.

Cardiac Xenotransplantation: Progress in Preclinical Models and Prospects for Clinical Translation

Avneesh K Singh  1 , Corbin E Goerlich  1 , Aakash M Shah  1 , Tianshu Zhang  1 , Ivan Tatarov  1 , David Ayares  2 , Keith A Horvath  3 , Muhammad M Mohiuddin  1
Affiliations
Review

Cardiac Xenotransplantation: Progress in Preclinical Models and Prospects for Clinical Translation

Avneesh K Singh et al. Transpl Int. .

Abstract

Survival of pig cardiac xenografts in a non-human primate (NHP) model has improved significantly over the last 4 years with the introduction of costimulation blockade based immunosuppression (IS) and genetically engineered (GE) pig donors. The longest survival of a cardiac xenograft in the heterotopic (HHTx) position was almost 3 years and only rejected when IS was stopped. Recent reports of cardiac xenograft survival in a life-sustaining orthotopic (OHTx) position for 6 months is a significant step forward. Despite these achievements, there are still several barriers to the clinical success of xenotransplantation (XTx). This includes the possible transmission of porcine pathogens with pig donors and continued xenograft growth after XTx. Both these concerns, and issues with additional incompatibilities, have been addressed recently with the genetic modification of pigs. This review discusses the spectrum of issues related to cardiac xenotransplantation, recent progress in preclinical models, and its feasibility for clinical translation.

Keywords: cardiac transplantation; heart transplantation; pre clinical model of xenotransplantation; transplantation; xenotransplantation.

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Conflict of interest statement

Author DA was employed by the company Revivicor Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Strategies for achieving success for long term cardiac xenograft survival.
FIGURE 2
FIGURE 2
Timeline showing the progress in pre-clinical model of cardiac xenotransplantation.
See this image and copyright information in PMC

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