CAJ | 학술논문

同种器官移植成功率的提高导致了供体器官的严重短缺.采用解剖学上与人类相近的动物,比如猪的器官可以解决这种危机.但从猪到人的器官移植需要克服很多障碍,包括免疫学,生理学及其伦理道德问题.超急性排斥反应是猪到人异种器官移植的首要免疫学障碍,目前主要通过敲除半乳糖α1,3半乳糖(galactose-α1,3-galactose,Gal)抗原来克服超急性排斥反应.除此之外,仍有其它的非-Gal抗原可能引起猪到人的移植物的失功,例如N-羟乙酰神经氨酸等.除了免疫学障碍,猪器官携带的病毒及可能引起的异种移植的潜在风险也不容忽视.虽然现在还没有明显的实验数据显示猪到人的病原体的感染,但当猪到人的免疫学障碍被克服后,感染将成为又一研究热点.
동충기관이식성공솔적제고도치료공체기관적엄중단결.채용해부학상여인류상근적동물,비여저적기관가이해결저충위궤.단종저도인적기관이식수요극복흔다장애,포괄면역학,생이학급기윤리도덕문제.초급성배척반응시저도인이충기관이식적수요면역학장애,목전주요통과고제반유당α1,3반유당(galactose-α1,3-galactose,Gal)항원래극복초급성배척반응.제차지외,잉유기타적비-Gal항원가능인기저도인적이식물적실공,례여N-간을선신경안산등.제료면역학장애,저기관휴대적병독급가능인기적이충이식적잠재풍험야불용홀시.수연현재환몰유명현적실험수거현시저도인적병원체적감염,단당저도인적면역학장애피극복후,감염장성위우일연구열점.
Great success in clinical allotransplantation recently has caused the shortage of available organs from deceased human donors. This crisis could be resolved by the use of organs from an anatomically suitableanimal, such as the pig. However, multiple hurdles need to be overcomed, including immunologic barriers, physiological differences and ethical concerns between pigs and humans. The hyperacute rejection was the first immunological barrier. Now it has recently been prevented by the breeding of pigs that do not express galactose-α1 ,3-galactose (Gal). In addition, there are other antipig antibodies against non-Gal or unidentified antigenic targets that may well be involved in graft destruction, including N-glycolylneuraminic acid and so on. Besides the immunological barriers, potential risks for infection transmitted from the xenograft donor to the recipient have also been investigated. Thus far, clinical xenotransplantation of pig tissues has not resulted in the transmission of viral infection to humans, significant risks for disease transmission from swine to humans have not been confirmed. If immunologic hurdles can be overcomed, it is reasonable to initiate carefully monitored clinical trials.