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中华移植杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 221 -226. doi: 10.3877/cma.j.issn.1674-3903.2023.04.003

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中国人体器官捐献与异种移植
叶啟发(), 兰佳男   
  1. 430071 武汉大学中南医院 武汉大学肝胆疾病研究院 武汉大学移植医学中心 移植医学技术湖北省重点实验室 国家人体捐献器官获取质量控制中心;410013 长沙,中南大学湘雅三医院 国家卫健委移植医学工程技术研究中心
    430071 武汉大学中南医院 武汉大学肝胆疾病研究院 武汉大学移植医学中心 移植医学技术湖北省重点实验室 国家人体捐献器官获取质量控制中心
  • 收稿日期:2023-05-09 出版日期:2023-08-25
  • 通信作者: 叶啟发
  • 基金资助:
    武汉大学中南医院2022年度医学科技创新平台建设匹配经费(PTPP2022007)

Organ donation in China and xenotransplantation

Qifa Ye(), Jia′nan Lan   

  1. Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, National Quality Control Center for Donated Organ Procurement, Wuhan 430071, China; Xiangya Third Hospital of Central South University, National Health Commission Research center of Transplant Medical Engineering Technology, Changsha 410013, China
    Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, National Quality Control Center for Donated Organ Procurement, Wuhan 430071, China
  • Received:2023-05-09 Published:2023-08-25
  • Corresponding author: Qifa Ye
引用本文:

叶啟发, 兰佳男. 中国人体器官捐献与异种移植[J]. 中华移植杂志(电子版), 2023, 17(04): 221-226.

Qifa Ye, Jia′nan Lan. Organ donation in China and xenotransplantation[J]. Chinese Journal of Transplantation(Electronic Edition), 2023, 17(04): 221-226.

中国人体器官捐献于2015年1月全面进入以公民逝世后器官捐献为来源的器官移植新时代,经过八年的改革实践及两年的专项整治,我国器官捐献与移植呈现出快速、跨越式发展,并迈入法制化、伦理化、科学化、规范化道路,与国际同轨,展现出高质量、健康可持续发展的良好态势。目前,我国器官捐献与移植数量位居亚洲第一、国际第二位,实现量质双升,并受到国际移植社会高度赞扬和支持。然而供受者的数量差异仍是器官移植医师不得不面临的现实问题,异种移植的发展可能是缓解器官短缺现状的有效手段,其临床推广需克服跨物种之间基因差异导致的严重并发症。本文就我国目前器官捐献与移植发展现状以及异种移植临床研究进展做一总结。

In January 2015, organ donation after citizens′ death has become the only legal source of organs in China. After 8 years of reform practice and 2 years of special rectification, organ donation and transplantation in our country show fast, leap-forward development on a legal, ethical, scientific and standardized road, and has shown a good trend of high-quality, healthy and sustainable development along the same track as the international community. At present, China′s organ donation and transplantation ranks first in Asia and second in the world, which has been highly praised and supported by the international transplant community. However, the huge quantitative difference between donors and recipients is still a realistic problem that organ transplant doctors have to face. The development of xenotransplantation may be an effective means to alleviate the current situation of organ shortage, and its clinical promotion needs to overcome the serious complications caused by cross-species genetic differences. This paper summarizes the current development status of organ donation and transplantation in China and the progress of clinical research on xenotransplantation.

1
石炳毅. 中国器官捐献与移植改革历程[J]. 中华医学信息导报2020, 18:21.
2
薛武军. 加强具有中国特色器官捐献与获取组织建设,促进我国器官移植事业快速发展[J/CD]. 实用器官移植电子杂志2021, 9(2):102-104.
3
黄伟,叶啟发,范晓礼,等. 中国人体器官获取组织发展与建设历程[J]. 武汉大学学报(医学版), 2021, 42(2):173-178.
4
王海波,史赢,周稚烨,等. 2019年中国器官捐献与移植等待现状分析[J]. 中华器官移植杂志2021, 42(6):324-325.
5
李羽抒,杨顺良. 创建中国特色的器官获取组织质量管理体系[J]. 器官移植2021, 12(4):369-375.
6
Lei T, Chen L, Wang K, et al. Genetic engineering of pigs for xenotransplantation to overcome immune rejection and physiological incompatibilities: the first clinical steps[J]. Front Immunol, 2022, 13:1031185.
7
Tu TY, Xu XL, Du XG, et al. Advances in innate immunity to overcome immune rejection during xenotransplantation[J]. Cells, 2022, 11(23):3865.
8
Ladowski JM, Hara H, Cooper DKC. The role of SLAs in xenotransplantation[J]. Transplantation, 2021, 105(2):300-307.
9
Xi J, Zheng W, Chen M, et al. Genetically engineered pigs for xenotransplantation: hopes and challenges[J]. Front Cell Dev Biol, 2022, 10:1093534.
10
Mohiuddin MM, Singh AK, Corcoran PC, et al. Chimeric 2C10R4 anti-CD40 antibody therapy is critical for long-term survival of GTKO.hCD46.hTBM pig-to-primate cardiac xenograft[J]. Nat Commun, 2016, 7:11138.
11
Zhang X, Li X, Yang Z, et al. A review of pig liver xenotransplantation: current problems and recent progress[J]. Xenotransplantation, 2019, 26(3):e12497.
12
Fishman JA. Risks of infectious disease in xenotransplantation[J]. N Engl J Med, 2022, 387(24):2258-2267.
13
Ibi Y, Nishinakamura R. Kidney bioengineering for transplantation[J]. Transplantation, 2023, 107(9):1883-1894.
14
Goldstone AB, Bacha EA, Sykes M. On cardiac xenotransplantation and the role of xenogeneic tolerance[J]. J Thorac Cardiovasc Surg, 2023, 166(3):968-972.
15
Breimer ME, Björck S, Svalander CT, et al. Extracorporeal ( "ex vivo" ) connection of pig kidneys to humans. I. Clinical data and studies of platelet destruction[J]. Xenotransplantation, 1996, 3(4):328-339.
16
Rydberg L, Björck S, Hallberg E, et al. Extracorporeal ( "ex vivo" ) connection of pig kidneys to humans. II. The anti-pig antibody response[J]. Xenotransplantation, 1996, 3(4):340-353.
17
Bengtsson A, Svalander CT, Mölne J, et al. Extracorporeal ( "ex vivo" ) connection of pig kidneys to humans. III. Studies of plasma complement activation and complement deposition in the kidney tissue[J]. Xenotransplantation, 1998, 5(3):176-183.
18
Montgomery RA, Stern JM, Lonze BE, et al. Results of two cases of pig-to-human kidney xenotransplantation[J]. N Engl J Med, 2022, 386(20):1889-1898.
19
Griffith BP, Goerlich CE, Singh AK, et al. Genetically modified porcine-to-human cardiac xenotransplantation[J]. N Engl J Med, 2022, 387(1):35-44.
20
Ekser B, Long C, Echeverri GJ, et al. Impact of thrombocytopenia on survival of baboons with genetically modified pig liver transplants: clinical relevance[J]. Am J Transplant, 2010, 10(2):273-285.
21
Yeh H, Machaidze Z, Wamala I, et al. Increased transfusion-free survival following auxiliary pig liver xenotransplantation[J]. Xenotransplantation, 2014, 21(5):454-464.
22
Shah JA, Patel MS, Elias N, et al. Prolonged survival following pig-to-primate liver xenotransplantation utilizing exogenous coagulation factors and costimulation blockade[J]. Am J Transplant, 2017, 17(8):2178-2185.
23
Mou L, Shi G, Cooper DKC, et al. Current topics of relevance to the xenotransplantation of free pig islets[J]. Front Immunol, 2022, 13:854883.
24
Nagaraju S, Bottino R, Wijkstrom M, et al. Islet xenotransplantation: what is the optimal age of the islet-source pig?[J]. Xenotransplantation, 2015, 22(1):7-19.
25
Shin JS, Min BH, Kim JM, et al. Failure of transplantation tolerance induction by autologous regulatory T cells in the pig-to-non-human primate islet xenotransplantation model[J]. Xenotransplantation, 2016, 23(4):300-309.
26
Ma D, Duan W, Li Y, et al. PD-L1 deficiency within islets reduces allograft survival in mice[J]. PLoS One, 2016, 11(3):e0152087.
27
Yao M, Domogatskaya A, Ågren N, et al. Cibinetide protects isolated human islets in a stressful environment and improves engraftment in the perspective of intra portal islet transplantation[J]. Cell Transplant, 2021, 30:9636897211039740.
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