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Review
. 2024 Aug;95(8):603-609.
doi: 10.1007/s00104-024-02093-y. Epub 2024 May 15.

[Xenotransplantation of solid organs]

[Article in German]
Michael Schmoeckel  1 , Matthias Längin  2   3 , Bruno Reichart  3   4 , Jan-Michael Abicht  2   3 , Martin Bender  2   3 , Joachim Denner  3   5 , Georg Marckmann  3   6 , Paolo Brenner  7   3 , Eckhard Wolf  3   8 , Christian Hagl  7   9
Affiliations
Review

[Xenotransplantation of solid organs]

[Article in German]
Michael Schmoeckel et al. Chirurgie (Heidelb). 2024 Aug.

Abstract
in English, German

Transplantation of genetically modified porcine hearts and kidneys could become a solution to the persistent shortage of human organ donors. Progress has been made in genetic engineering of donor pigs, preservation techniques after organ harvesting and immunosuppression using co-stimulation blockade with anti-CD40/CD40L monoclonal antibodies. Progress has also been made in in the development of methods that detect pathogenic porcine viruses and prevent their transmission to the recipient. As normal land breed pig organs continue to grow in the recipient to their original size, different pig breeds (such as Auckland Island pigs) are now used which reach a final size suitable for humans. Alternatively, a knock-out of the growth hormone receptor gene has been established, e.g., in the 10GM genetically modified pigs from Revivicor/United Therapeutics, USA. The first clinical pilot studies including patients suffering from terminal heart failure are expected to start in Germany in about 2 years.

Die Transplantation genetisch veränderter Schweineherzen und -nieren kann in den nächsten Jahren eine Lösung für den bestehenden Mangel an Organspendern darstellen. Fortschritte im Bereich des „Genetic Engineering“, aber auch verbesserte Organpräservationstechniken, eine Immunsuppression mit Kostimulationsblockade (Anti-CD40/CD40L-mAb) sowie eine verbesserte virologische Diagnostik, um eine Übertragung von pathogenen Schweineviren auf den Empfänger zu verhindern, haben hierzu beigetragen. Da Landrasse-Schweineorgane auch im Transplantatempfänger ihre Originalgröße erreichen, werden nun Schweinerassen verwendet, die entweder ein für den Menschen passendes Endgewicht erreichen (z. B. Auckland Island-Schweine) oder deren Wachstumshormonrezeptor genetisch inaktiviert wurde (z. B. in 10fach genetisch veränderten Schweinen der Fa. Revivicor/United Therapeutics, USA). Mit der ersten klinischen Pilotstudie an terminal Herzkranken wird in Deutschland in ca. 2 Jahren gerechnet.

Keywords: Genetic engineering; Heart; Kidney; Organ preservation; Pilot study.

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Figures

Abb. 1
Abb. 1
Auckland Island-Schweine im Tierversuchsgut der LMU, München-Oberschleißheim. (Mit freundl. Genehmigung, © LMU München, alle Rechte vorbehalten)
See this image and copyright information in PMC

References

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    1. Reichart B, Längin M, Radan J et al (2020) Pig-to-non-human primate heart transplantation: The final step toward clinical xenotransplantation ? J Heart Lung Transplant 39:751–757 - PubMed
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    1. Ma D, Hirose T, Lassiter G et al (2022) Kidney transplantation from triple-knockout pigs expressing multiple human proteins in cynomolgus macaques. Am J Transplant 22:46–57 - PMC - PubMed

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