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David K.C. Cooper,Hidetaka Hara,Mohamed Ezzelarab,Rita Bottino,Massimo Trucco,Carol Phelps,David Ayares,Yifan Dai.Journal of Biomedical Research,2013,27(4):/span>
The potential of genetically-engineered pigs in providing an alternative source of organs and cells for transplantation
Received:April 28, 2013
DOI:10.7555/JBR.27.20130063
Keywordspig, blood transfusion; pig, genetic-engineered; pig, islets; pig, organs; xenotransplantation
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Author Institution
David K.C. Cooper Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA
Hidetaka Hara Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA
Mohamed Ezzelarab Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA
Rita Bottino Division of Immunogenetics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15261, USA
Massimo Trucco Division of Immunogenetics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15261, USA
Carol Phelps Revivicor, Inc, Blacksburg, VA 24060, USA
David Ayares Revivicor, Inc, Blacksburg, VA 24060, USA
Yifan Dai Jiangsu Key Laboratory of Xenotransplantation, Nanjing Medical University, Nanjing, Jiangsu , China
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Abstract
There is a critical shortage of organs, cells, and corneas from deceased human donors worldwide. There are also shortages of human blood for transfusion. A potential solution to all of these problems is the transplantation of organs, cells, and corneas from a readily available animal species, such as the pig, and the transfusion of red blood cells from pigs into humans. However, to achieve these ends, major immunologic and other barriers have to beovercome. Considerable progress has been made in this respect by the genetic modification of pigs to protect their tissues from the primate immune response and to correct several molecular incompatibilities that exist between pig and primate. These have included knockout of genes responsible for the expression of major antigenic targets for primate natural anti-pig antibodies, insertion of human complement- and coagulation-regulatory transgenes, and knockdown of swine leukocyte antigens that stimulate the primate's adaptive immune response. As a result of these manipulations, the administration of novel immunosuppressive agents, and other innovations, pig hearts have now functioned in baboons for 6-8 months, pig islets have maintained normoglycemia in diabetic monkeys for > 1 year, and pig corneas have maintained transparency for several months. Clinical trials of pig islet trans?plantation are already in progress. Future developments will involve further genetic manipulations of the organ-source pig, with most of the genes that are likely to be beneficial already identified.
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