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This title provides an illuminating examination of the current state of xenotransplantation – grafting or transplanting organs or tissues between members of different species – and how it might move forward into the clinic. To be sure, this is a critical topic, as a major problem that remains worldwide is an inadequate supply of organs from deceased human donors, severely limiting the number of organ transplants that can be performed each year. Based on presentations given at a major conference on xenotransplantation, this title includes important views from many leading experts who were invited to present their data and opinions on how xenotransplantation can advance into the clinic. Attention was concentrated on pig kidney and heart transplantation as it is in regard to these organs that most progress has been made. Collectively, these chapters effectively highlight the many advantages of xenotransplantation to patients with end-stage organ failure, thereby encouraging the mapping of a concrete pathway to clinical xenotransplantation. The book is organized across 22 chapters, beginning with background information on clinical and experimental xenotransplantation. Following this are discussions addressing how pigs can be genetically engineered for their organs to be resistant to the human immune response through deletion of pig xenoantigens, and the insertion of ‘protective’ human transgenes. Subsequent chapters analyze complications that arise in practice, comparing allotransplant and xenotransplant rejection. The selection of the ideal patients for the first clinical trials is discussed. Finally, the book concludes with an analysis on the regulatory, economic, and social aspects of this research, including FDA perspectives and the sensitive, psychosocial factors regarding allotransplantation and xenotransplantation. A major and timely addition to the literature, Clinical Xenotransplantation will be of great interest to all researchers, physicians, and academics from other disciplines with an interest in xenotransplantation.
Xenotransplantation involves the transplantation of cells, tissues, and whole organs from one species to another. Interest in animal-to-human xenotransplants has been spurred by the continuing shortage of donated human organs and by advances in knowledge concerning the biology of organ and tissue rejection. The scientific advances and promise, however, raise complex questions that must be addressed. This book considers the scientific and medical feasibility of xenotransplantation and explores the ethical and public policy issues surrounding the possibility of renewed clinical trials. The volume focuses on the science base of xenotransplantation, public health risks of infectious disease transmission, and ethical and public policy issues, including the views of patients and their families.
With profound implications for human health and longevity, "Xeno" is a fascinating exploration of the medical, ethical, legal, and social issues surrounding the future of organ transplantation. 17 halftones. Line illustrations.
Some developing biotechnologies challenge accepted legal and ethical norms because of the risks they pose. Xenotransplantation (cross-species transplantation) may prolong life but may also harm the xeno-recipient and the public due to its potential to transmit infectious diseases. These trans-boundary diseases emphasise the global nature of advances in health care and highlight the difficulties of identifying, monitoring and regulating such risks and thereby protecting individual and public health. Xenotransplantation raises questions about how uncertainty and risk are understood and accepted, and exposes tensions between private benefit and public health. Where public health is at risk, a precautionary approach informed by the harm principle supports prioritising the latter, but the issues raised by genetically engineered solid organ xenotransplants have not, as yet, been sufficiently discussed. This must occur prior to their clinical introduction because of the necessary changes to accepted norms which are needed to appropriately safeguard individual and public health.
There is a critical and continuing shortage of organs and cells from deceased human donors for the purposes of transplantation into patients with terminal organ failure. The use of organs and cells from pigs i.e., cross-species transplantation, or xenotransplantation could resolve this problem. Recollections of Pioneers in Xenotransplantation Research is a collection of reminiscences by surgeons and scientists who, over the past 50 years, have made major contributions to research into achieving successful transplantation of pig organs and cells into primates. It records the personal work of 22 researchers from North America, Asia, Europe, and Australasia who developed this field, which will have an immense impact on the future medical care of patients with such diverse conditions as heart and kidney failure, diabetes, corneal blindness, and Parkinsons disease. A pig organ transplanted into a human or nonhuman primate is rejected within minutes. To overcome this immunological barrier, pigs have been genetically-engineered to protect their tissues from the primate immune response. Today, life-supporting organs from pigs with up to six genetic modifications have functioned for more than a year in nonhuman primates, and the blood sugar of diabetic monkeys has been controlled for more than two years by the transplantation of insulin-producing pancreatic islet cells from pigs. Clinical trials of pig islet and corneal transplantation have already been undertaken, and trials of organ transplants are currently being planned. The pioneering researchers who contributed to the early development of this field highlight their own roles, and record their personal recollections of the other scientists and surgeons with whom they collaborated. They do not confine themselves to the scientific progress they made, but comment on the roles of industry and academia in moving the field forward. Recollections of Pioneers in Xenotransplantation Research will be of interest to physicians, scientists, and the lay person with an interest in transplantation or in the care of patients with life-threatening diseases, but also to those interested to understand the potential of genetic-engineering in science and medicine. The book provides a historical record of the research that has contributed to an advance in medicine that has been called the next great medical revolution. Within a few years, this new form of therapy is likely to impact every family in the developed world.
Recently, remarkable progress has been made in the area of preclinical xenotransplantation experiments. Surprisingly, a heterotopic heart from the gene-editing pig continued to beat for almost 2.5 years, when implanted in the monkey abdomen, and a pig life-supporting kidney could also function for over 1.3 years in monkeys. Concerning islets, islets from gene-editing pigs could work for more than one year in monkeys. It is noteworthy that one group reported a survival of adult wild-type pig islets of over 600 days. On the other hand, the progress in these preclinical trials strongly affected not only the xenotransplantation study itself but regeneration studies to use pigs as a scaffold to foster human induced pluripotent stem cells.
There have been tremendous strides in cellular transplantation in recent years, leading to accepted practice for the treatment of certain diseases, and use for many others in trial phases. The long history of cellular transplantation, or the transfer of cells from one organism or region of the body to another, has been revolutionized by advances in stem cell research, as well as developments in gene therapy. Cellular Transplants: From Lab to Clinic provides a thorough foundation of the basic science underpinning this exciting field, expert overviews of the state-of-the-art, and detailed description of clinical success stories to date, as well as insights into the road ahead. As highlighted by this timely and authoritative survey, scale-up technologies and whole organ transplantation are among the hurdles representing the next frontier. The contents are organized into four main sections, with the first covering basic biology, including transplant immunology, the use of immunosuppressive drugs, stem cell biology, and the development of donor animals for transplantation. The next part looks at peripheral and reconstructive applications, followed by a section devoted to transplantation for diseases of the central nervous system. The last part presents efforts to address the key challenges ahead, such as identifying novel transplantable cells and integrating biomaterials and nanotechnology with cell matrices. - Provides detailed description of clinical trials in cell transplantation - Review of current therapeutic approaches - Coverage of the broad range of diseases addressed by cell therapeutics - Discussion of stem cell biology and its role in transplantation
Illuminates the wondrous yet disquieting medical realm of organ transplantation by drawing on the voices of those most deeply involved: transplant recipients, clinical specialists, and the surviving kin of deceased organ donors. This ethnographic study explores how these parties think about death, loss, and mourning.