Miniature swine as organ donors for man: Strategies for prevention of xenotransplant‐associated infections

Abstract

Abstract: Xenotransplantation could potentially overcome limitations in organ transplantation resulting from a shortage of donor organs. Transplantation from miniature swine raises concerns over the potential introduction of new infectious agents into humans. These “direct zoonotic infections” or “xenoses” derived from swine fall into four categories: (1) microbial agents known to cause infection in humans (traditional zoonoses);(2) “species specific” organisms restricted to infection of the donor xenograft tissues by the absence of receptors or other factors needed for growth in human cells;(3) organisms of broad “host range” capable of infection of tissues outside the xenograft in the immunocompromised transplant recipient;and (4) organisms, such as retroviruses, of unknown quantity and with unmeasured capacity for causing disease in humans. The behavior of donor‐derived xenoses in immunocompromised xenotransplant recipients cannot be predicted. The ability of human‐derived microbial agents to infect porcine xenografts, and the capacity of the human immune system to inhibit such infections, also merit investigation. Experimental assessment of the infectious disease risks associated with xenotransplantation is important and practical.