title: Xenograft bioprosthetic heart valves: Past, present and future.
abstract: The transplantation (implantation) of xenograft heart valves into humans has been carried out for >50 years. There has been considerable research into making this form of xenotransplantation successful, though it is not perfect yet. We review the understanding of the immune response to xenograft heart valves. Important steps in the history include understanding (i) the importance of glutaraldehyde in decreasing the immune response and (ii) the relationship between calcification (which is the main problem leading to xenograft failure) and the immune response. We subsequently discuss the importance of identifying xenoantigens that are important in leading to xenograft valve failure, and the potential of genetically-engineered pigs to allow the development of the 'ideal' heart valve for clinical valve replacement.
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, Winnipeg Regional Health Authority and St. Boniface Hospital, Winnipeg, Manitoba, Canada. Electronic address: rmanji@sbgh.mb.ca.
authors.forename: Rizwan A
authors.initials: RA
authors.lastname: Manji
authors.affiliation: Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Whayoung
authors.initials: W
authors.lastname: Lee
authors.affiliation: Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: David K C
authors.initials: DKC
authors.lastname: Cooper
mesh_terms: D000818:Animals; D030801:Animals, Genetically Modified; D001705:Bioprosthesis / Q000639:trends*; D002114:Calcinosis / Q000209:etiology; D006084:Graft Rejection / Q000276:immunology; D006349:Heart Valve Diseases / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000639:trends*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods / Q000639:trends*; D064593:Heterografts; D006801:Humans; D013552:Swine
keywords: Calcification; Gal; Genetically-modified; Glutaraldehyde; Heart valves; NeuGc; Pigs; Xenograft rejection