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Outwitting evolution.

David K C Cooper1

  • 1Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA. cooperdk@upmc.edu

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This review highlights key advancements in organ transplantation, including hypothermic perfusion storage and gene-edited pig organs. These innovations show promise for improving transplant success and addressing organ shortages.

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Area of Science:

  • Transplantation immunology
  • Surgical innovation
  • Biotechnology

Background:

  • The author reflects on a career dedicated to advancing cardiothoracic surgery and experimental transplantation.
  • Key contributions span organ preservation, donor management, xenotransplantation immunology, and islet cell transplantation.

Purpose of the Study:

  • To provide a retrospective overview of significant milestones in transplantation research and practice.
  • To acknowledge the collaborative efforts and individuals who have shaped the field.

Main Methods:

  • Development of hypothermic perfusion storage for donor hearts.
  • Investigation of hormonal therapy in brain-dead organ donors.
  • Identification of Gal alpha 1,3Gal as a key xenoantigen.
  • Xenotransplantation of genetically modified pig organs (hearts and islets) into non-human primates.

Main Results:

  • Successful clinical application of hypothermic heart preservation.
  • Improved understanding of immune responses in xenotransplantation.
  • Achieved 2- to 6-month survival for gene-edited pig hearts in baboons.
  • Demonstrated 3- to 12-month normoglycemia after pig islet transplantation in diabetic monkeys.

Conclusions:

  • Significant progress has been made in overcoming barriers to xenotransplantation.
  • Collaborative research and international associations like the IXA are crucial for advancing the field.
  • The author's career highlights the transformative potential of innovative approaches in transplantation medicine.