Liver xenotransplantation

Madhukar S. Patel, Nathan Louras, Parsia A. Vagefi

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Purpose of review There continues to be an inadequate organ supply and lack of effective temporary support, for patients with liver failure. The purpose of this review is to discuss recent progress in the field of orthotopic pig-to-nonhuman primate (NHP) liver xenotransplantation (LXT). Recent findings From 1968 to 2012, survival in pig-to-NHP LXT was limited to 9 days, initially due to hyperacute rejection which has been ameliorated through use of genetically engineered donor organs, but ultimately because of profound thrombocytopenia, thrombotic microangiopathy, and bleeding. Most recently, however, demise secondary to lethal coagulopathy has been avoided with LXT of α(1,3)-galactosyltransferase knockouts and cytomegalovirus-negative porcine xenografts into baboons receiving exogenous administration of coagulation factors and co-stimulation blockade, establishing that a porcine liver is capable of supporting NHP life for nearly a month. Summary Continued consistent achievement of pig-to-NHP LXT survival beyond 2 weeks justifies consideration of a clinical application as a bridge to allotransplantation for patients with acute hepatic failure. Further genetic modifications to the donor, as well as additional studies, are required in order to apply LXT as destination therapy.

Original languageEnglish (US)
Pages (from-to)535-540
Number of pages6
JournalCurrent Opinion in Organ Transplantation
Volume22
Issue number6
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Fingerprint

Heterologous Transplantation
Swine
Primates
Liver
Tissue Donors
Thrombotic Microangiopathies
Galactosyltransferases
Blood Coagulation Factors
Survival
Acute Liver Failure
Papio
Liver Failure
Cytomegalovirus
Heterografts
Thrombocytopenia
Hemorrhage

Keywords

  • bridge
  • liver
  • nonhuman primate
  • pig
  • xenotransplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation

Cite this

Liver xenotransplantation. / Patel, Madhukar S.; Louras, Nathan; Vagefi, Parsia A.

In: Current Opinion in Organ Transplantation, Vol. 22, No. 6, 01.12.2017, p. 535-540.

Research output: Contribution to journalReview article

Patel, Madhukar S. ; Louras, Nathan ; Vagefi, Parsia A. / Liver xenotransplantation. In: Current Opinion in Organ Transplantation. 2017 ; Vol. 22, No. 6. pp. 535-540.
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