“转基因猪心”可期?异种心脏移植研究进展  

Research progress in cardiac xenotransplantation:can“genetically modified pig heart”be expected?

作　　者：杨兆华 王春生 YANG Zhao-hua;WANG Chun-sheng(Department of Cardiac Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院心外科,上海200032

出　　处：《复旦学报（医学版）》2023年第4期600-605,612,共7页Fudan University Journal of Medical Sciences

基　　金：上海市科委重大项目(024119001)。

摘　　要：心脏移植是终末期心力衰竭的有效治疗手段,但供体严重不足制约了心脏移植的广泛开展。异种移植由于供体器官来源不受数量和时间的限制,可以更好地满足临床需要,最有可能成为解决供需矛盾的可靠方法。近年来,由于基因编辑猪的应用及新的免疫抑制方案实施,心脏异种移植实验研究方面取得了巨大的进展,相继克服了超急性排斥反应、早期移植物失功、人畜共患病及异种移植器官过度生长等难题。在此基础上,研究者开展了一系列准临床级别的人体试验,取得了巨大的突破。但是,异种移植仍面临如何维持移植心脏长期存活及开展临床试验所涉及的伦理和行政监管等诸多问题的挑战。本文通过对异种移植研究现状及面临的问题进行综述,为心脏异种移植的进一步实验研究和临床试验提供更多的思考。Heart transplantation has become one of the effective treatments for end-stage heart failure,but the imbalance between organ supply and the demand for human organs limits its use.Because the source of donor organs is not restricted by quantity and time,xenotransplantation has been considered as an attractive option to solve the shortage of donated human organs.In recent years,the application of genetically modified pigs and the implementation of efficacious and safe immunosuppression had made great progress in xenotransplantation research,and the problems of hyperacute rejection,early graft failure,zoonoses and excessive growth of xenotransplantation organs had been overcome successively.On this basis,a series of pre-clinical human trials had been carried out and great breakthroughs had been made.However,xenotransplantation still faces many challenges,such as how to maintain the long-term survival of transplanted heart and the ethical and administrative supervision involved in clinical trials.This article attempts to provide more thoughts for further laboratory studies and clinical trials of heart xenotransplantation by summarizing the current research and problems of xenotransplantation.

关 键 词：异种移植 基因修饰猪 免疫排斥 心脏移植 

分 类 号：R654.2[医药卫生—外科学]