临床异种器官移植十大问题的思考

Reflection on 10 problems of clinical xenotransplantation

供者短缺是影响器官移植发展的一大难题,而异种器官移植可能是解决这一难题的有效途径。随着基因编辑技术的发展以及新型免疫抑制剂的研发,异种器官移植领域取得了许多突破性的进展,但大多数研究目前仍处于临床前阶段。近期,世界首例基因编辑猪到人心脏移植的成功极大地鼓舞了科研工作者。但临床异种器官移植仍面临很多重要问题,包括克服排斥反应、控制炎症反应、调节凝血紊乱、提高移植物生理相容性、重视种间感染风险、优化免疫抑制方案、筛选供体基因编辑类型、选择适宜受者人群、完善异种移植指南、明确大众认可度等,本文就以上十大问题进行总结,以期为促进异种器官移植的临床应用提供参考。

The shortage of donors restricts the development of organ transplantation.Xenotransplantation might act as an effective approach to resolve this problem.With the advancement of genome editing technologies as well as research and development of novel immunosuppressant,lots of breakthroughs have been achieved in the field of xenotransplantation.Nevertheless,a majority of researches are still in the preclinical stage.Recently,the success of the world’s first genetically engineered pig-to-human heart transplantation has greatly inspired researchers.However,clinical xenotransplantation still faces an array of problems,including counteracting rejection,controlling inflammation,regulating coagulation disorder,improving physiological compatibility of xenografts,paying attention to the risk of interspecific infection,optimizing immunosuppressive regimen,screening donor genome editing types,selecting suitable recipients,modifying xenotransplantation guidelines,and awareness of public recognition,etc.In this article,these 10 problems were summarized,aiming to provide reference for promoting the clinical application of xenotransplantation.