title: Recent advances in understanding xenotransplantation: implications for the clinic.
abstract: The results of organ and cell allotransplantation continue to improve, but the field remains limited by a lack of deceased donor organs. Xenotransplantation, for example, between pig and human, offers unlimited organs and cells for clinical transplantation. The immune barriers include a strong innate immune response in addition to the adaptive T-cell response. The innate response has largely been overcome by the transplantation of organs from pigs with genetic modifications that protect their tissues from this response. T-cell-mediated rejection can be controlled by immunosuppressive agents that inhibit costimulation. Coagulation dysfunction between the pig and primate remains problematic but is being overcome by the transplantation of organs from pigs that express human coagulation-regulatory proteins. The remaining barriers will be resolved by the introduction of novel genetically-engineered pigs. Limited clinical trials of pig islet and corneal transplantation are already underway.
authors.affiliation: a 1 Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: David Kc
authors.initials: DK
authors.lastname: Cooper
authors.affiliation: b 2 Institute of Cellular Therapeutics, Allegheny-Singer Research Institute, Pittsburgh, PA, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Bottino
mesh_terms: D000818:Animals; D030801:Animals, Genetically Modified / Q000235:genetics / Q000276:immunology; D016039:Corneal Transplantation / Q000379:methods*; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000276:immunology / Q000379:methods; D013552:Swine / Q000235:genetics / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology; D014181:Transplantation Immunology; D014183:Transplantation, Heterologous / Q000379:methods*
keywords: genetically-engineered pig; immunobiology; islets pig; organs pig; xenotransplantation