Lung transplantation. Xenotransplantation.
The continued and growing success of lung allotransplantation has intensified the worldwide shortage of donor organs. Yet, xenotransplantation remains a daunting challenge. Additional molecular incompatibilities and unforeseen complications will continue to be discovered. Progress has been made, notably on the generation of alpha-Gal double knockout pigs. Progressive increases in organ survival times have been seen for most organs after significant investments of time and money. The lung continues to be an organ with the lowest supply of cadaveric donors and the least potential for expanded living donation or mechanical alternatives. As such, the impetus for xenotransplantation is strong. The lung appears to be exquisitely sensitive to xenograft rejection and resistant to strategies that have been moderately successful in other organs. A complex program involving genetically modified donor organs, recipient preparation for antibody removal or tolerance promotion, and multitargeted drug therapy will likely be required for successful clinical application.
D000818:Animals; D006084:Graft Rejection / Q000209:etiology / Q000276:immunology; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects / Q000276:immunology / Q000379:methods*; D023001:Transplantation Tolerance / Q000276:immunology; D014183:Transplantation, Heterologous / Q000941:ethics* / Q000276:immunology*