Kidney Xenotransplantation
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Abstract
Kidney transplantation is the best treatment for patients with end-stage kidney disease. However, there are still many patients today who have not received a kidney transplant and are still on the waiting lists. The gap between the demand for kidney transplants and the limited availability of human organs has led to prolonged waiting times, higher mortality rates, and a significant burden on healthcare systems worldwide. Kidney xenotransplantation, the transplantation of kidneys from non-human species, most commonly pigs, into humans, has emerged as a potential solution to the global shortage of donor organs for patients with end-stage kidney disease. Despite promising advances in genetic engineering, immunosuppressive therapies, and xenotransplantation protocols, the clinical application of kidney xenotransplants remains challenging. These include immune rejection, potential zoonotic infections, and long-term organ viability. This review explores the current state of kidney xenotransplantation, focusing on recent breakthroughs in gene editing technologies such as CRISPR-Cas9, which enable the creation of genetically modified pigs with organs more compatible with human recipients. We also discuss the immunological hurdles and strategies to modulate the human immune response. We also explore the efforts to eliminate the transmission of porcine viruses.
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