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中华移植杂志(电子版) ›› 2021, Vol. 15 ›› Issue (06) : 375 -382. doi: 10.3877/cma.j.issn.1674-3903.2021.06.010

综述

猪-人异种心脏移植展望
杨锦然1, 李新长1, 傅俊1, 杨华1, 张友福1, 龙成美1,()   
  1. 1. 330006 南昌,江西省人民医院器官移植科
  • 收稿日期:2021-09-22 出版日期:2021-12-25
  • 通信作者: 龙成美

Prospect of pig-to-human cardiac xenotransplantation

Jinran Yang1, Xinchang Li1, Jun Fu1, Hua Yang1, Youfu Zhang1, Chengmei Long1,()   

  1. 1. Department of Organ Transplantation, Jiangxi Provincial People′s Hospital, Nanchang 330006, China
  • Received:2021-09-22 Published:2021-12-25
  • Corresponding author: Chengmei Long
引用本文:

杨锦然, 李新长, 傅俊, 杨华, 张友福, 龙成美. 猪-人异种心脏移植展望[J/OL]. 中华移植杂志(电子版), 2021, 15(06): 375-382.

Jinran Yang, Xinchang Li, Jun Fu, Hua Yang, Youfu Zhang, Chengmei Long. Prospect of pig-to-human cardiac xenotransplantation[J/OL]. Chinese Journal of Transplantation(Electronic Edition), 2021, 15(06): 375-382.

心力衰竭患者呈逐年增加趋势,心脏移植是治疗此类患者的有效手段,但供心短缺严重制约心脏移植的发展。异种心脏移植(CXTx)可扩大供器官来源,可在很大程度上缓解供器官短缺的问题。猪-人CXTx一直是人类探索的重要方向。本文针对CXTx的发展历程及特殊问题进行综述,从CXTx模型建立、现状、存在难题、供体猪基因改造、异种移植免疫、凝血功能改变、免疫抑制剂应用、异种移植潜在感染风险及如何甄选首例猪-人CXTx受者等相关问题出发,提出猪-人CXTx进入临床试验的展望,为更好地进行猪-人CXTx提供理论参考。

Heart failure patients are increasing year by year, and heart transplantation is an effective treatment for heart failure patients, but the shortage of donors is the main problem of heart transplantation. Cardiac xenotransplantation (CXTx) can expand the source of donated organs and alleviate the contradiction of organ shortage to a great extent. Pig-to-human CXTx is an important research direction. This paper summarizes the development and special problems of CXTx, and puts forward the prospect of pig-to-human CXTx into the clinical trial from various problems including model building, current situation, the existing problems, gene modification of pig, immunosuppression in xenotransplantation, coagulation function change, immunosuppressant application, potential risk of infection and first CXTx recipient selection. So as to provide theoretical reference for better pig-to-human CXTx.

表1 目前常见的异种心脏移植供体猪需改造的基因及其作用[31,32,33,34,35,36,37,38,39,40]
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