Induction of immunological tolerance in the pig-to-baboon xenotransplantation model : studies aimed at achieving mixed hematopoietic chimerism and preventing associated thrombotic complications

The outcome of clinical organ transplantation has dramatically improved since the introduction of cyclosporine (CyA) in 1979 and of other, more recently introduced, immunosuppressive agents such as azathioprine, mycophenolate mofetil, tacrolimus and sirolimus. Furthermore, due to more refined surgical techniques and peri operative management, prolonged survival of allografts is achieved. Due to its relative success, the inclusion criteria for potential organ transplant recipients have been broadened, resulting in an even greater shortage of donor organs. The number of patients with end-stage organ failure that die awaiting organ transplantation is steadily increasing, mainly because of the shortage of appropriate donor organs. Many clinicians and investigators believe that strategies directed at expanding the allogeneic donor pool will not be sufficient to resolve this problem of organ shortage. In contrast, successful xenotransplantation - the transplantation of tissues and/or organs between two different species - has the potential of providing an unlimited supply of donor organs that would be available when required. However, major immunological barriers, as well as other important issues, at present prevent the implementation of xenotransplantation clinically.

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