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  • 陈忠华,孙煦勇.临床异种移植百年进展(述评)[J].广西科学,2022,29(3):411-414,422.    [点击复制]
  • CHEN Zhonghua,SUN Xuyong.One Hundred Years of Progress in Clinical Xenotransplantation (Review)[J].Guangxi Sciences,2022,29(3):411-414,422.   [点击复制]
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临床异种移植百年进展(述评)
陈忠华1, 孙煦勇2
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(1.华中科技大学同济医学院附属同济医院器官移植研究所, 湖北武汉 430030;2.广西医科大学第二附属医院移植医学中心, 广西移植医学工程技术研究中心, 广西器官捐献与移植研究重点实验室, 广西南宁 530007)
摘要:
美国最近连续报道4例基因工程猪供给人的异种器官移植,这些进展打破了异种移植临床研究领域近30年的沉静。尤其是实验性的猪心脏移植取得初步成功,引发了广泛的关注。异种移植面向未来的临床应用迈出了关键性一步。这4个案例,无论是创新精神、技术进步、审批流程,还是伦理学的同步跟进,都值得我国同行学习和借鉴。30年来,基因工程(GE)动物器官已经能在非人类灵长类动物(NHPs)模型中长时间存活。这些实验中,预存抗体、补体激活、凝血状态等机制参与的超急性排异反应基本上得到有效控制。异种移植已经达到临床应用的起跑点。然而,未来仍然有四大问题需要解决:免疫排斥、生物安全、跨种适配和伦理心理。本文简要概括临床异种移植百年来的主要进展,其困难程度可见一斑,但希望和探索从未终止。
关键词:  异种移植  基因工程猪  心脏移植  肾脏移植  器官移植
DOI:10.13656/j.cnki.gxkx.20220720.002
投稿时间:2022-04-02
基金项目:
One Hundred Years of Progress in Clinical Xenotransplantation (Review)
CHEN Zhonghua1, SUN Xuyong2
(1.Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China;2.Guangxi Key Laboratory of Organ Donation and Transplantation, Guangxi Transplantation Medicine Research Center of Engineering Technology, Center of Transplantation Medicine, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530007, China)
Abstract:
Recently, four consecutive cases of genetically engineered pig to human renal and cardiac xenotransplantation had been sustainably reported in United States.These advances have broken the silence of clinical research in xenotransplantation for nearly 30 years. In particular, experimental pig heart transplantation has achieved initial success, which has attracted wide attention.The future clinical application of xenotransplantation has taken a key step.These four cases, whether theirs spirit of innovation, technological progress, approval process, or the synchronous follow-up of ethics, are worth learning and using for reference by peers in China.Over the past 30 years, genetically engineered (GE) animal organs have been able to survive in non-human primates (NHPs) models for a long time. In these experiments, the hyper-acute rejection reactions involved in the mechanisms of pre-existing antibodies, complement activation, and coagulation state were basically effectively controlled.Xenotransplantation has reached the starting point of clinical application. However, four major issues remain to be addressed in the future:Immune rejection, biosafety, cross-species adaptation and ethical psychology. The main progress of clinical xenotransplantation in the past 100 years has been briefly summarized in this article. The difficulty is obvious, but the hope and exploration have never ended.
Key words:  xenotransplantation  genetically engineered pig  heart transplantation  kidney transplantation  organ transplantation

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