異種移植之新進展

Recent Advances in Xenotransplantation

將動物器官移植到人類體內異種移植（xenotransplantation），是解決器官短缺（organ shortage）的方案之一，最近2項異種器官移植的臨床試驗，分別是基因改造豬的心臟與腎臟成功地移植至人體，顯示人性化的豬器官，可以避免人類接受者的超急性排斥，異種移植的目標確實有可能實現。此次豬腎及豬心移植之臨床試驗，均使用美國生物科技公司Revivicor生產的基因改造豬「GalSafe」。Revivicor利用複製羊技術以及基因編輯技術，改造了豬的10個基因，讓「GalSafe」豬腎及豬心能減少排斥程度、被人體接受，增加了試驗成功率。本文將說明異種移植之排斥，克服排斥之方法，與最新之異種移植臨床試驗。本文也說明臺灣的異種移植研究進展，包含豬的基因轉殖與基因剔除（雙基因(GGTA1/CMAH)剔除）。

Transplanting animal organs into humans (xenotransplantation) is one of the solutions to organ shortage. Two recent clinical xenotransplantations of heart and kidney procured from genetically modified pigs have shown encouraging outcomes. Successful transplantation into human indicates that humanized porcine organs can avoid hyperacute rejection of human recipients and that the routine practice of xenotransplantation is indeed foreseeable. The clinical trials of porcine kidney and porcine heart transplantation used the genetically modified pig 'GalSafe' produced by American biotechnology company Revivicor. This company has modified 10 genes of pigs using sheep Dolly-cloning technology and gene editing technology so that the 'GalSafe' porcine organs shall elicit a little degree of rejection and be acceptable by the human body. This article explained the mechanism of xenotransplantation rejection and avoiding approaches; the latest clinical trials of xenotransplantation was also described. This article also described the progress of xenotransplantation research in Taiwan, including gene transfer and gene knockout in pigs (double gene (GGTA1/CMAH) knockout).