Infection in xenotransplantation: opportunities and challenges

Current Opinion in Organ Transplantation
J A Fishman

Abstract

Posttransplantation infections are common. It is anticipated that infection will be no less common in xenotransplantation recipients. Prolonged xenograft survivals have resulted from advances in immunosuppressive strategies and development of swine that decrease host immune responses via genetic manipulation, notably CRISPR/cas9 manipulation. As prospects for clinical trials improve, consideration of the unique infectious risks posed by xenotransplantation reemerge. Organisms likely to cause infection in human recipients of porcine xenografts are unknown in advance of clinical trials. Microbiological screening of swine intended as xenograft donors can be more intensive than is currently feasible for human allograft donors. Monitoring infection in recipients will also be more intensive. Key opportunities in infectious diseases of xenotransplantation include major technological advances in evaluation of the microbiome by unbiased metagenomic sequencing, assessments of some risks posed by porcine endogenous retroviruses (PERVs) including antiretroviral susceptibilities, availability of swine with deletion of genomic PERVs, and recognition of the rapidly changing epidemiology of infection in swine worldwide. Unknown infectious risk...Continue Reading

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Citations

Nov 13, 2019·Nucleic Acids Research·Jennifer R SmithMary E Shimoyama
May 7, 2020·Current Opinion in Organ Transplantation·Paolo Brenner, Maks Mihalj
Aug 7, 2020·Progress in Retinal and Eye Research·Chang Ho YoonMee Kum Kim
Mar 12, 2021·Transplantation Reviews·Maria VascoClaudio Napoli
May 7, 2020·Current Opinion in Organ Transplantation·Paolo Brenner, Maks Mihalj
Mar 25, 2021·Xenotransplantation·Raphael P H MeierManuel Pascual
Jun 18, 2021·Journal of Cardiac Surgery·Leonardo Rufino GarciaLeonardo Antônio Mamede Zornoff

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