“The publication ‘Consistent success in life-supporting porcine cardiac xenotransplantation’ by Professor Bruno Reichart’s group in Munich is a significant landmark in progress towards transplantation into humans of pig hearts, for the treatment of end stage heart disease.
Prof Christopher McGregor, Professor of Cardiac Surgery, Institute of Cardiovascular Science, UCL, said: “This new research can thus help both to bring organ xenotransplantation a step closer to human application, and to improve organ preservation techniques for human heart transplantation.”
The work is also important because it highlights the role that organ preservation may play in stimulating the immune system of the transplant recipient – if the organ preservation is optimised, it can help to damp down the strong immune response to the new organ. “Langin and colleagues have now shown that by using a new drug regime, alongside a better way of preserving the donor pig heart outside the body, using oxygenated low temperature (+8 oC) continuous perfusion with a new solution including red blood cells, pig hearts survived for more than 6 months after transplantation into non-human primates (another version of xenotransplantation). Scientists have developed genetically modified pigs which could in theory reduce this strong immune response, but even then, significant problems have remained. The possibility to use animal organs for transplantation to overcome organ shortages has been discussed for decades, but has never become a reality because the human body aggressively rejects animal organ transplants because of multiple and strong immune reactions. “This is an impressive study on transplantation of organs between species, a process called xenotransplantation.
FIRST HEART FROM GENETICALLY ALTERED PIG FREE
Prof Barry Fuller, Professor in Surgical Science & Low Temperature Medicine, UCL & Royal Free London NHS Foundation Trust Transplantation Services, said:
To be seriously considered for use in humans, studies will have to demonstrate greater success than a mechanical pumping device, and ensure that potential safety complications due to viral transmission from the transplanted heart to the recipient can be discounted.” However the results still fall short of the need for more extensive and longer-term studies before the first pig heart is transplanted into a human. “This new research takes us a step closer to the use of pig hearts in humans. However, it is still not clear whether longer-term organ damage and rejection may remain a problem. This has been largely overcome by the development of genetically modified pigs, that have successively reduced this complication. The biggest hurdle is rapid rejection of the pig heart by the human immune system. “The potential to solve the shortage of available human hearts for transplantation by using pig hearts has been an aspiration for scientists for more than 40 years, but has proved to be a difficult journey. Prof Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: Research published in Nature demonstrates that baboons implanted with genetically modified pig hearts have been able to survive for up to 195 days. Expert reaction to study looking at long-term function of genetically modified pig hearts transplanted into baboons
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