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- W2023682663 abstract "All forms of transplantation except autografts and transplants between genetically identical twins involve crossing genetically encoded barriers. In allotransplantation we try to lower the barriers by a variety of means: we match the major histocompatibility genes and the blood groups of donor-recipient pairs and perform crossmatches to minimise the effects of prior sensitisation to any HLA antigens which may be mismatched. We prefer related over unrelated donors, because the former pick up some matches not only for what we know but inadvertently for unknown but nevertheless relevant genetic differences. Despite these efforts we still have to overcome the effects of other unmatched, untested or unknown genetic differences by immunosuppressing the recipient; this is not always successful and always comes at a price.Of course xenotransplantation is no exception and what is more the genetically encoded barriers are even higher. However, because a pig is a pig and not a human we can directly attack the genetic barriers – we can genetically modify the pig and so provide a genetic solution to a genetic problem and even go a little further.We generally think of potential genetic modifications under headings based on the technology employed: gene knockouts – to remove particular pig characteristics, archetypically the αGal epitope; and transgenesis – to add human characteristics to the pig tissue e.g. the human complement regulator DAF. However to be comprehensive we need to broaden that view and one approach is to think of genetic modifications as either prophylactic or therapeutic. This allows us to take advantage of the enormous power of genetic engineering and to think about making changes which go beyond simply trying to make the pig donor tissue a little more like a human allograft i.e. beyond prophylactic modifications. Some therapeutic genetic modifications may even overcome problems which still are an issue in allotransplantation e.g. local expression of immunosuppressive molecules within xenografts may minimise the need for systemic immunosuppression." @default.
- W2023682663 created "2016-06-24" @default.
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- W2023682663 date "2009-06-01" @default.
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- W2023682663 title "Xenotransplantation: The next generation of engineered animals" @default.
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- W2023682663 doi "https://doi.org/10.1016/j.trim.2008.10.003" @default.
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