Editorials

Transplanting porcine hearts to humans

BMJ 1996; 312 doi: http://dx.doi.org/10.1136/bmj.312.7032.651 (Published 16 March 1996) Cite this as: BMJ 1996;312:651
  1. Fritz H Bach,
  2. Lewis Thomas
  1. Lewis Thomas professor Harvard Medical School, New England Deaconess Hospital, Boston, MA 02215, USA

    Understanding the mechanisms gives cause for optimism

    The proposal to use transgenic swine hearts, which express a human gene, as donor organs for humans has sparked new interest in xenotransplantation (transplanting tissues from one species to another). A normal pig heart transplanted to an untreated primate is destroyed by hyperacute rejection within hours or minutes. Primates have pre-existing xenoreactive natural antibodies, which attach to the endothelial cells lining the vessels of the donor organ as soon as blood flow is established after transplantation. Recipient complement is activated, and the organ is rejected.1 2 Despite this overwhelmingly strong rejection reaction, many researchers remain optimistic that clinical xenotransplantation will become a reality.

    Such optimism is based on several factors. The emergence of molecular genetics has provided tools to allow a detailed understanding of the mechanisms of rejection and permitted genetic engineering of donor animals. In addition, endothelial cells in the donor organ, which may …

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