Brief clinical history

Clinical interest in xenogeneic transplantation has stemmed from the shortage of organs available for human transplantation, originally because cadaver donors were not often available before the concept of brain death was accepted in the 1960s, and more recently because the extraordinary success of clinical allotransplantation has again created a demand which exceeds the supply of organs.

Reemtsma was the first to report a technically successful xenotransplant to a human patient in 1963. He performed a series of kidney transplants from chimpanzees, one of which survived for 9 months with good renal function before the patient died from complications of immunosuppression. Over the next several years, Starzl and several others performed kidney, liver and heart transplants from baboons, chimpanzees and pigs to human recipients without long-term success.

Clinical xenotransplantation began again with a heart transplant from a baboon to 'Baby Fae' in 1985. Since then there have been two baboon-ro-human liver transplants, a series of islet transplants from fetal pigs to humans, transplantation of fetal pig neural cells to patients with Parkinson disease, and at least one bone marrow transplant from a baboon to a patient with the acquired immune deficiency syndrome (AIDS). In addition, livers from pigs and other species have been used to maintain patients with fulminant hepatic failure by intermittent ex vivo perfusion of an animal organ, and there has been at least one effort at 'bridge' transplantation in which a pig liver was transplanted to a critically ill human patient as a first step toward subsequent replacement by an allogeneic organ. At this point, however, no clinically successful xenotransplant has been reported in the sense of achieving patient survival for one year based on the ongoing physiologic function of the transplanted tissue.

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