Infection in xenotransplantation.
Advances in transplantation immunology have enhanced the possibility of xenotransplantation as a therapeutic option for end-stage organ failure. The potential spread of animal-derived pathogens to the recipient and to the general population, termed "xenosis," is a potential complication of interspecies transplantation. Recognition of such novel infections may be complicated by infections due to altered microbiologic behavior and clinical symptomatology of these organisms, particularly in the immunocompromised xenograft recipient. Particular concern exists over the activation of latent viruses, including retroviruses, from xenograft tissues. Based on experience with human allogeneic transplantation, those pathogens considered most likely to cause human disease can be excluded prospectively from herds of animals developed for organ donation. Research is needed into the activation and behavior of retroviruses and other potential pathogens in xenotransplantation. Xenotransplantation may also provide unique opportunities not only for the care of patients with organ failure, but in the therapy of individuals with chronic infections to which the xenograft may be resistant. Clinical protocols must be developed so as to enhance the safety of the recipient and of the community-at-large.
Fishman
J A
JA
Infectious Disease and Transplantation Units, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA. jfishman@partners.org
D000818:Animals; D006801:Humans; D007239:Infections / Q000635:transmission*; D018570:Risk Assessment; D014183:Transplantation, Heterologous; D014777:Virus Diseases / Q000635:transmission; D015047:Zoonoses / Q000635:transmission