Neonatal cardiac transplantation for hypoplastic left heart syndrome (HLHS) is associated with excellent long-term survival compared to older recipients. However, heart transplantation for neonates is greatly limited by the critical shortage of donor hearts, and by the associated mortality of the long pre-transplant waiting period. This led to the development of staged surgical palliation as the first-line surgical therapy for HLHS. Recent advances in genetic engineering and xenotransplantation have provided the potential to replicate the excellent results of neonatal cardiac allotransplantation while eliminating wait-list-associated mortality through genetically modified pig-to-human neonatal cardiac xenotransplantation. The elimination of the major pig antigens in addition to the immature B-cell response in neonates allows for the potential to induce B-cell tolerance. Additionally, the relatively mature neonatal T-cell response could be reduced by thymectomy at the time of operation combined with donor-specific pig thymus transplantation to "reprogram" the host's T-cells to recognize the xenograft as host tissue. In light of the recent significantly increased graft survival of genetically-engineered pig-to-baboon cardiac xeno...Continue Reading
Interaction between human natural anti-alpha-galactosyl immunoglobulin G and bacteria of the human flora.
Identification of alpha-galactosyl and other carbohydrate epitopes that are bound by human anti-pig antibodies: relevance to discordant xenografting in man
Newborn baboon serum anti-alpha galactosyl antibody levels and cytotoxicity to cultured pig kidney (PK15) cells
Anti-GaL IgG antibodies in sera of newborn humans and baboons and its significance in pig xenotransplantation
Role of the thymus in transplantation tolerance in miniature swine. I. Requirement of the thymus for rapid and stable induction of tolerance to class I-mismatched renal allografts
Survival analysis and risk factors for mortality in transplantation and staged surgery for hypoplastic left heart syndrome
The influence of partial or total thymectomy during open heart surgery in infants on the immune function later in life
Thymic function and impaired maintenance of peripheral T cell populations in children with congenital heart disease and surgical thymectomy
Late onset of development of natural anti-nonGal antibodies in infant humans and baboons: implications for xenotransplantation in infants
Impact of ABO-incompatible listing on wait-list outcomes among infants listed for heart transplantation in the United States: a propensity analysis
Complications after the Norwood operation: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database
Neurodevelopment and quality of life for children with hypoplastic left heart syndrome: current knowns and unknowns
Early survival after heart transplant in young infants is lowest after failed single-ventricle palliation: a multi-institutional study
Quality of life in pediatric heart transplant recipients: a comparison with children with and without heart disease
T-cell-based immunosuppressive therapy inhibits the development of natural antibodies in infant baboons
Thymic transplantation in pig-to-nonhuman primates for the induction of tolerance across xenogeneic barriers
Trends in the indications and survival in pediatric heart transplants: a 24-year single-center experience in 307 patients
ABO-incompatible heart transplantation in early childhood: an international multicenter study of clinical experiences and limits
Human dominant-negative class II transactivator transgenic pigs - effect on the human anti-pig T-cell immune response and immune status
Risk factors for mortality or delisting of patients from the pediatric heart transplant waiting list
Mortality and morbidity after retransplantation after primary heart transplant in childhood: an analysis from the registry of the International Society for Heart and Lung Transplantation
Transplantation-free survival and interventions at 3 years in the single ventricle reconstruction trial
Genetically engineered pigs and target-specific immunomodulation provide significant graft survival and hope for clinical cardiac xenotransplantation
Clinical course and outcome predictors of critically ill infants with complete DiGeorge anomaly following thymus transplantation
Results of heart transplantation following failed staged palliation of hypoplastic left heart syndrome and related single ventricle anomalies
Initial in vivo experience of pig artery patch transplantation in baboons using mutant MHC (CIITA-DN) pigs
Survival and right ventricular performance for matched children after stage-1 Norwood: Modified Blalock-Taussig shunt versus right-ventricle-to-pulmonary-artery conduit
Outcomes and risk factors for listing for heart transplantation after the Norwood procedure: An analysis of the Single Ventricle Reconstruction Trial
A perspective on the potential detrimental role of inflammation in pig orthotopic heart xenotransplantation.
Evidence that sensitization to triple-knockout pig cells will not be detrimental to subsequent allotransplantation.
Birth defects encompass structural and functional alterations that occur during embryonic or fetal development and are present since birth. The cause may be genetic, environmental or unknown and can result in physical and/or mental impairment. Here is the latest research on birth defects.
B cell Tolerance
B cell tolerance is maintained through mechanisms that can reversibly or irreversibly silence autoreactive B lymphocytes. Here is the latest research.