Xenotransplantation--how far have we come?
The immunologic barriers to xenotransplantation are summarized and approaches to overcome them briefly reviewed. Intensive investigation is being directed to the problem of acute humoral xenograft rejection, which is the major current barrier. Although the induced antibody response appears to be prevented by combination therapy with an anti-CD154 monoclonal antibody and mycophenolate mofetil, deposition of natural anti-Gal antibody on the graft endothelial cells appears to be sufficient to lead to rejection or a state of consumptive coagulopathy. Approaches towards the induction of tolerance are described. The potential microbiologic risks and physiologic incompatibilities of pig-to-human organ transplantation are also briefly discussed.
Transplantation Biology Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, 02129, USA. david.cooper@tbrc.mgh.harvard.edu
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Cooper
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Gollackner
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Knosalla
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Teranishi
D000818:Animals; D004730:Endothelium, Vascular / Q000166:cytology; D005818:Genetic Engineering; D006084:Graft Rejection; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D013552:Swine; D013950:Thymus Gland / Q000637:transplantation; D018183:Transplantation Chimera; D014183:Transplantation, Heterologous / Q000276:immunology*