J Korean Soc Transplant.  2009 Dec;23(3):203-213. 10.4285/jkstn.2009.23.3.203.

Current Status and Future Perspectives of Xenotransplantation

• Park CG
• Kim JS
• Shin JS
• Kim YH
• Kim SJ

• KMID: 1819842
• DOI: http://doi.org/10.4285/jkstn.2009.23.3.203

Abstract

Xenotransplantation using pigs as the transplant source holds great promise to resolve the severe shortage of human organ donors. Although stem-cell-derived organ and tissue regeneration have a potential to solve this as well for the future, it still remains as very early experimental phase. Likewise, artificial organs and mechanical devices have been simply used for bridge therapy to transplant. Therefore, xenotransplantation might provide the most imminent solution to the scarcity of human organ donors. In the last two decades, major progress has been made in understanding the mechanisms of xenografts rejection, zoonotic infections including porcine endogenous retrovirus (PERV) and production of genetically engineered pigs including alpha1,3-galactosyltransferase-deficient pigs. With these elaborations, it is now on the threshold of first clinical application. Particularly promising first target is porcine pancreatic islet xenotransplantation. Graft survival has been prolonged to almost one year in the non-human primate study and is waiting for the development of relatively non-toxic or clinically applicable immunosuppressive or tolerance-inducing regimens. This review highlights the currently known obstacles to translate xenotransplantation into clinical therapies and the possible strategies to overcome these hurdles, as well as current status and future perspective for clinical xenotransplantaion.

Keyword

Xenotransplantation; Porcine; Islet transplantation; Transplant rejection; Immune tolerance

MeSH Terms

Artificial Organs
Endogenous Retroviruses
Graft Rejection
Graft Survival
Humans
Immune Tolerance
Islets of Langerhans
Islets of Langerhans Transplantation
Primates
Regeneration
Rejection (Psychology)
Swine
Tissue Donors
Transplantation, Heterologous
Transplants

Figure

• 

  Fig. 1. Shortage of organ donor in Korea (Data from Korean Network for Organ Sharing, KONOS).

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