心脏异种移植术后感染的研究进展

Research progress on infection after cardiac xenotransplantation

感染是心脏移植患者术后最常见的严重影响预后的并发症。猪源心脏异种移植到非人灵长类动物通常需要强力的免疫抑制治疗,且许多猪源病毒可能感染受体动物,导致人畜共患病。术后感染会影响移植心脏的生存时间,激活并加剧移植心脏的炎症反应和免疫排斥反应。尽管改进的免疫抑制方案、高效及时的监测方法、基因编辑技术的进步以及术前供体筛查显著降低了异种移植术后感染并发症的发生率,但在当前的异种移植研究和实践中,平衡免疫抑制治疗与感染风险仍具有挑战性。本文总结了针对心脏异种移植后各类病原体的感染监测、预防和治疗现状,基于异种移植实验的经验,我们希望在未来的研究中制定更有效的围手术期免疫抑制和感染控制策略。

Infection is the most common complication that seriously affects the prognosis after heart transplantation.Xenotransplantation of porcine hearts into non-human primates typically requires robust immunosuppressive therapy,and many pig-derived viruses have the potential to infect recipient animals,leading to zoonosis.Postoperative infections can affect the survival time of the transplanted heart,activate and aggravate inflammatory responses and immune rejection of the transplanted heart.Although improved immunosuppressive regimens,efficient and timely monitoring methods,progress in gene editing technology,and preoperative donor screening have markedly reduced the incidence of infectious complications following xenotransplantation,balancing immunosuppressive therapy with infection risk remains challenging in current xenotransplantation research and practice.This paper summarizes the current status of infection surveillance,prevention,and treatment of various pathogens after cardiac xenotransplantation.Based on the experience of xenotransplantation experiments,we aspire to formulate more effective perioperative immunosuppression and infection control strategies in future researches.