The Case for Cardiac Xenotransplantation in Neonates: Is Now the Time to Reconsider Xenotransplantation for Hypoplastic Left Heart Syndrome?

Pediatric Cardiology
David ClevelandDavid K C Cooper

Abstract

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

References

Dec 20, 1985·JAMA : the Journal of the American Medical Association·L L BaileyW B Jolley
Jan 6, 1983·The New England Journal of Medicine·W I NorwoodD D Hansen
Jan 15, 1995·Transplantation·R J KaplonJ L Platt
Oct 12, 2000·Journal of the American College of Cardiology·P C JenkinsG T O'Connor
Mar 15, 2001·The New England Journal of Medicine·L J WestJ G Coles
Oct 5, 2001·Journal of the American College of Cardiology·P C JenkinsA N Tosteson
Oct 3, 1953·Nature·R E BILLINGHAMP B MEDAWAR
Apr 17, 2004·Clinical and Experimental Immunology·J H EysteinsdottirH M Ogmundsdottir
Aug 4, 2005·The Journal of Thoracic and Cardiovascular Surgery·Douglas R JohnstonJoren C Madsen
Jan 21, 2006·The Journal of Immunology : Official Journal of the American Association of Immunologists·Brenda M OgleJeffrey L Platt
Sep 14, 2007·Transplant International : Official Journal of the European Society for Organ Transplantation·Pleunie P M RoodDavid K C Cooper
Oct 9, 2007·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Stacey M Pollock-BarZivAnne I Dipchand
Dec 25, 2007·Clinical Immunology : the Official Journal of the Clinical Immunology Society·Ivan K ChinnM Louise Markert
Jun 30, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Rebecca A PetroskiElfriede Pahl
Oct 13, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Leonard L Bailey
Jan 1, 2010·Xenotransplantation·Carol J PhelpsDavid L Ayares
Mar 20, 2010·Clinical Immunology : the Official Journal of the Clinical Immunology Society·M Louise MarkertElizabeth A McCarthy
Jan 4, 2012·Journal of the American College of Cardiology·Jeffrey A FeinsteinGerard R Martin
Feb 14, 2012·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Melanie D EverittUNKNOWN Pediatric Heart Transplant Study Investigators
Mar 3, 2012·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Karen UzarkJames W Varni
May 2, 2012·Current Cardiology Reviews·Richard E Chinnock, Leonard L Bailey
May 9, 2012·Methods in Molecular Biology·Kazuhiko Yamada, Joseph Scalea
May 29, 2012·The Annals of Thoracic Surgery·Rochus K VoellerCharles B Huddleston
Jan 12, 2013·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Simon UrschelLori J West
Nov 5, 2013·The Journal of Thoracic and Cardiovascular Surgery·Aamir JeewaAnne I Dipchand
Jan 28, 2014·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Jennifer ConwayAnne I Dipchand
Apr 8, 2014·Circulation·Jane W NewburgerUNKNOWN Pediatric Heart Network Investigators
Jul 8, 2014·The Journal of Thoracic and Cardiovascular Surgery·Muhammad M MohiuddinKeith A Horvath
Jul 30, 2014·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jan Hau LeeDavid A Turner
Jan 21, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Bahaaldin AlsoufiKirk Kanter
Sep 1, 2015·International Journal of Surgery·Muhammad M MohiuddinChristopher G A McGregor
Sep 15, 2015·The Journal of Pathology·David Kc CooperDavid Ayares
Oct 10, 2015·Journal of the American College of Cardiology·Kavitha N PundiFrank Cetta
Dec 4, 2015·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Aparna KulkarniDaphne T Hsu

❮ Previous
Next ❯

Citations

Aug 28, 2020·Pediatric Transplantation·Mohamed BikhetHayato Iwase
Sep 19, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Daniel J HurstWayne Paris
May 7, 2020·Current Opinion in Organ Transplantation·Paolo Brenner, Maks Mihalj
Oct 7, 2020·Pediatric Transplantation·Luz A PadillaWaldemar F Carlo
Dec 19, 2020·Xenotransplantation·David K C Cooper, David C Cleveland
May 7, 2020·Current Opinion in Organ Transplantation·Paolo Brenner, Maks Mihalj
May 1, 2021·Xenotransplantation·Hidetaka HaraDavid K C Cooper

❮ Previous
Next ❯

Related Concepts

Related Feeds

Birth Defects

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.