title: Pig Liver Xenotransplantation: A Review of Progress Toward the Clinic.
abstract: Experience with clinical liver xenotransplantation has largely involved the transplantation of livers from nonhuman primates. Experience with pig livers has been scarce. This brief review will be restricted to assessing the potential therapeutic impact of pig liver xenotransplantation in acute liver failure and the remaining barriers that currently do not justify clinical trials. A relatively new surgical technique of heterotopic pig liver xenotransplantation is described that might play a role in bridging a patient with acute liver failure until either the native liver recovers or a suitable liver allograft is obtained. Other topics discussed include the possible mechanisms for the development of the thrombocytopenis that rapidly occurs after pig liver xenotransplantation in a primate, the impact of pig complement on graft injury, the potential infectious risks, and potential physiologic incompatibilities between pig and human. There is cautious optimism that all of these problems can be overcome by judicious genetic manipulation of the pig. If liver graft survival could be achieved in the absence of thrombocytopenia or rejection for a period of even a few days, there may be a role for pig liver transplantation as a bridge to allotransplantation in carefully selected patients.
authors.affiliation: 1 The Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA. 2 Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shianxi, People's Republic of China. 3 Transplant Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: David K C
authors.initials: DK
authors.lastname: Cooper
authors.forename: Ke-Feng
authors.initials: KF
authors.lastname: Dou
authors.forename: Kai-Shan
authors.initials: KS
authors.lastname: Tao
authors.forename: Zhao-Xu
authors.initials: ZX
authors.lastname: Yang
authors.forename: A Joseph
authors.initials: AJ
authors.lastname: Tector
authors.forename: Burcin
authors.initials: B
authors.lastname: Ekser
mesh_terms: D000818:Animals; D003165:Complement System Proteins / Q000502:physiology; D006085:Graft Survival; D006801:Humans; D017114:Liver Failure, Acute / Q000601:surgery*; D016031:Liver Transplantation; D010215:Papio; D010587:Phagocytosis; D013552:Swine; D014183:Transplantation, Heterologous
chemical_list: D003165:Complement System Proteins