Cardiac Xenotransplantation: Challenges, Evolution, and Advances.

Area of Science:

• Cardiovascular Surgery
• Transplantation Immunology
• Xenotransplantation

Background:

• Rising demand for heart transplants due to advanced heart failure.
• Critical shortage of donor organs worldwide.
• Xenotransplantation (XTx) as a promising solution.

Purpose of the Study:

• Review historical advances in xenotransplantation.
• Discuss challenges and innovations in pig-to-human heart transplantation.
• Propose a framework for advancing clinical XTx.

Main Methods:

• Review of historical data and landmark pig-to-human heart transplantations.
• Analysis of scientific innovations in genetic manipulation for XTx.
• Discussion of immunologic, infectious, and physiological barriers.

Main Results:

• Successful first pig-to-human heart transplantation achieved.
• Genetic engineering has enabled progress in cross-species transplantation.
• Significant challenges remain for widespread clinical implementation.

Conclusions:

• Xenotransplantation holds significant potential to address organ shortages.
• Overcoming immunological and physiological hurdles is critical for success.
• A structured framework is proposed to guide future clinical translation of XTx.