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Ann Thorac Surg 2000;70:320-326
© 2000 The Society of Thoracic Surgeons

Current review

Cardiac xenotransplantation: clinical experience and future direction

David H. Adams, MDa, Raymond H. Chen, MD, PhDa, Alexander Kadner, MDa

a Division of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

Address reprint requests to Dr Adams, Cardiac Surgery, Brigham and Women’s Hospital, 15 Francis St, Boston, MA 02115
e-mail: dadams{at}partners.org

The shortage of human organs has focused research on finding an animal source of replacement organs. The immunological barriers to xenotransplantation are now more clearly defined, allowing retrospective interpretation of past clinical experience in humans. Due to physiological compatibilities as well as ethical and infectious considerations, pigs have now emerged as the most likely source of future xenografts. The introduction of transgenic pigs expressing human complement regulatory proteins and new immunosuppressive regimens have shown early promise in the laboratory, although further advancements are needed to advance to clinical trials. Additional clarification of infectious risks and patient strategies are remaining obstacles to application in the clinical arena.






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