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Fedson S, Lavee J, Bryce K, Egan T, Olland A, Kanwar M, Courtwright A, Holm AM. Ethical considerations in xenotransplantation of thoracic organs - a call for a debate on value based decisions. J Heart Lung Transplant 2024; 43:1033-1038. [PMID: 38775760 DOI: 10.1016/j.healun.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 06/03/2024] Open
Abstract
Xenotransplant covers a broad ethical territory and there are several ethical questions that have arisen in parallel with the technological advances that have allowed the first porcine transplants to occur. This brief communication highlights ethical considerations regarding heart and lung xenotransplantation, with an emphasis on unresolved value-based concerns in the field. The aim of this text is therefore to encourage the readers to consider the vast potential of this emerging technique to do good, but also the risk of doing harm, and to participate in a discussion. The list of questions presented here is not exhaustive but hopefully represents some of the questions that appear to be most pressing as the field advances. The focus is on the value-based, or ethical questions, not the questions related to the practical medical procedures.
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Affiliation(s)
- Savitri Fedson
- Baylor College of Medicine; Michael E DeBakey VA Medical Center, Houston, Texas.
| | - Jacob Lavee
- Heart Transplantation Unit, Leviev Cardiothoracic Center, Sheba Medical Center, Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Kelly Bryce
- Behavioral Health, Henry Ford Health System; Transplant Institute, Henry Ford Health System, Detroit, Michigan
| | - Tom Egan
- Division of Cardiothoracic Surgery, Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Anne Olland
- Department of Thoracic Surgery, University Hospital Strasbourg; Inserm UMR 1260 "Regenerative Nanomedicine", University of Strasbourg, Strasbourg, France
| | - Manreet Kanwar
- Cardiovascular Institute, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Andrew Courtwright
- Division of Pulmonary and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Are Martin Holm
- Department of Respiratory Medicine, Oslo University Hospital; Institute of Clinical Medicine, University of Oslo, Norway
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2
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Zeng C, Wu J, Li J. Pyruvate Kinase M2: A Potential Regulator of Cardiac Injury Through Glycolytic and Non-glycolytic Pathways. J Cardiovasc Pharmacol 2024; 84:1-9. [PMID: 38560918 PMCID: PMC11230662 DOI: 10.1097/fjc.0000000000001568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
ABSTRACT Adult animals are unable to regenerate heart cells due to postnatal cardiomyocyte cycle arrest, leading to higher mortality rates in cardiomyopathy. However, reprogramming of energy metabolism in cardiomyocytes provides a new perspective on the contribution of glycolysis to repair, regeneration, and fibrosis after cardiac injury. Pyruvate kinase (PK) is a key enzyme in the glycolysis process. This review focuses on the glycolysis function of PKM2, although PKM1 and PKM2 both play significant roles in the process after cardiac injury. PKM2 exists in both low-activity dimer and high-activity tetramer forms. PKM2 dimers promote aerobic glycolysis but have low catalytic activity, leading to the accumulation of glycolytic intermediates. These intermediates enter the pentose phosphate pathway to promote cardiomyocyte proliferation and heart regeneration. Additionally, they activate adenosine triphosphate (ATP)-sensitive K + (K ATP ) channels, protecting the heart against ischemic damage. PKM2 tetramers function similar to PKM1 in glycolysis, promoting pyruvate oxidation and subsequently ATP generation to protect the heart from ischemic damage. They also activate KDM5 through the accumulation of αKG, thereby promoting cardiomyocyte proliferation and cardiac regeneration. Apart from glycolysis, PKM2 interacts with transcription factors like Jmjd4, RAC1, β-catenin, and hypoxia-inducible factor (HIF)-1α, playing various roles in homeostasis maintenance, remodeling, survival regulation, and neovascularization promotion. However, PKM2 has also been implicated in promoting cardiac fibrosis through mechanisms like sirtuin (SIRT) 3 deletion, TG2 expression enhancement, and activation of transforming growth factor-β1 (TGF-β1)/Smad2/3 and Jak2/Stat3 signals. Overall, PKM2 shows promising potential as a therapeutic target for promoting cardiomyocyte proliferation and cardiac regeneration and addressing cardiac fibrosis after injury.
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Affiliation(s)
- Chenxin Zeng
- The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, China
- Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, China
| | - Jiangfeng Wu
- The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, China
- Institute of Organ Fibrosis and Targeted Drug Delivery, China Three Gorges University, Yichang, China; and
| | - Junming Li
- The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, China
- Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, China
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3
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Iltis AS, Silverman HJ, Sade RM. Research ethics: Must subjects waive the right to withdraw from a xenotransplant clinical trial? J Thorac Cardiovasc Surg 2024; 167:1880-1884. [PMID: 37454725 DOI: 10.1016/j.jtcvs.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Ana S Iltis
- Department of Philosophy and Center for Bioethics, Health and Society, Wake Forest University, Winston-Salem, NC
| | - Henry J Silverman
- Department of Medicine, University of Maryland, School of Medicine, Baltimore, Md
| | - Robert M Sade
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC.
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George AJ. Ethics, virtues and xenotransplantation. Perfusion 2024; 39:334-343. [PMID: 36382884 PMCID: PMC10900854 DOI: 10.1177/02676591221140767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Early in 2022 the first pig to human cardiac xenotransplant was performed. The graft initially performed well, and rejection was well controlled. However, the graft failed, and the patient died 60 days after the procedure. The ethical issues relating to xenotransplantation include the risk/benefit to the individual, the risk of porcine-derived infectious agents crossing into humans, animal welfare and rights, issues of human and animal identity and concerns relating to fair allocation of organs and appropriate use of resources.These ethical issues are often addressed using emotional arguments, or through consequentialist or deontological lens. An alternative is to use approaches based on virtue ethics to understand the moral purpose (telos) of the research and the virtues (character traits) needed to be a good research clinician. In this review we will consider the virtues of justice, courage, temperance and practical wisdom, as well as the role of clinical curiosity, and their application to xenotransplantation. This provides an alternative approach for the clinical academic and others involved in the research to reflect on their practice.
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Affiliation(s)
- Andrew Jt George
- Department of Surgery and Cancer, Imperial College London, London, UK
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Hurst DJ, Padilla L, Schiff T, Parent B. Revisiting the Use of Ulysses Contracts in Xenotransplantation. Transplantation 2024; 108:369-373. [PMID: 37246302 DOI: 10.1097/tp.0000000000004679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Xenotransplantation clinical trials may begin soon. A persistent risk of xenotransplantation, known for decades, is the possibility that a xenozoonotic infection could be transferred from a xenograft to its recipient and then to other human contacts. Because of this risk, guidelines and commentators have advocated for xenograft recipients to agree to either long-term or lifelong surveillance mechanisms. METHODS For the past few decades, one solution that has been proposed to ensure that xenograft recipients will comply with surveillance protocols is the use of a heavily modified Ulysses contract, which we review. RESULTS These contracts are most often used in psychiatry, and their application to xenotransplantation has been espoused several times with minimal criticism. CONCLUSIONS In this article, we argue against the applicability of Ulysses contracts in xenotransplantation based upon (1) the telos of the advance directive that may not be applicable to this clinical context, (2) the suspect nature of enforcing Ulysses contracts in xenotransplantation, and (3) the ethical and regulatory hurdles that such enforcement would require. Although our focus is on the US regulatory landscape in preparation for clinical trials, there are applications globally.
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Affiliation(s)
- Daniel J Hurst
- Department of Family Medicine, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ
| | - Luz Padilla
- Department of Epidemiology and Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Tamar Schiff
- Division of Medical Ethics, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY
| | - Brendan Parent
- Division of Medical Ethics, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY
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Kwon DH, Gim GM, Yum SY, Jang G. Current status and future of gene engineering in livestock. BMB Rep 2024; 57:50-59. [PMID: 38053297 PMCID: PMC10828428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/23/2023] [Accepted: 12/04/2023] [Indexed: 12/07/2023] Open
Abstract
The application of gene engineering in livestock is necessary for various reasons, such as increasing productivity and producing disease resistance and biomedicine models. Overall, gene engineering provides benefits to the agricultural and research aspects, and humans. In particular, productivity can be increased by producing livestock with enhanced growth and improved feed conversion efficiency. In addition, the application of the disease resistance models prevents the spread of infectious diseases, which reduces the need for treatment, such as the use of antibiotics; consequently, it promotes the overall health of the herd and reduces unexpected economic losses. The application of biomedicine could be a valuable tool for understanding specific livestock diseases and improving human welfare through the development and testing of new vaccines, research on human physiology, such as human metabolism or immune response, and research and development of xenotransplantation models. Gene engineering technology has been evolving, from random, time-consuming, and laborious methods to specific, time-saving, convenient, and stable methods. This paper reviews the overall trend of genetic engineering technologies development and their application for efficient production of genetically engineered livestock, and provides examples of technologies approved by the United States (US) Food and Drug Administration (FDA) for application in humans. [BMB Reports 2024; 57(1): 50-59].
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Affiliation(s)
- Dong-Hyeok Kwon
- Laboratory of Theriogenology, College of Veterinary Medicine, Research Institute for Veterinary Science, BK21 FOUR Future Veterinary Medicine Leading Education & Research Center, Seoul National University, Seoul 08826, Korea
| | | | | | - Goo Jang
- Laboratory of Theriogenology, College of Veterinary Medicine, Research Institute for Veterinary Science, BK21 FOUR Future Veterinary Medicine Leading Education & Research Center, Seoul National University, Seoul 08826, Korea
- LARTBio Inc., Gwangmyeong 14322, Korea
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Wang B, Qin Z, Li M, Arner A, Steen S. Pharmacological and mechanical properties of isolated pig coronary veins. Front Physiol 2023; 14:1275736. [PMID: 38028806 PMCID: PMC10651723 DOI: 10.3389/fphys.2023.1275736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Recent successful cardiac transplantation from pig to non-human primates and the first pig-to-human transplantation has put the focus on the properties of the pig heart. In contrast to the coronary arteries, the coronary veins are less well characterized and the aim was to examine the mechanical and pharmacological properties of coronary veins in comparison to the arteries. Vessel segments from the left anterior descending coronary artery (LAD) and the concomitant vein were isolated from pig hearts in cardioplegia and examined in vitro. The wall thickness, active tension and active stress at optimal circumference were lower in coronary veins, reflecting the lower intravascular pressure in vivo. Reverse transcription polymerase chain reaction (RT-PCR) analysis of myosin isoforms showed that the vein could be characterized as having a slower smooth muscle phenotype compared to the artery. Both vessel types contracted in response to the thromboxane agonist U46619 with EC50 values of about 20 nM. The artery contracted in response to acetylcholine. Precontracted arteries relaxed in noradrenaline and substance P. In contrast, the veins relaxed in acetylcholine, contracted in noradrenaline and were unresponsive to substance P. In conclusion, these results demonstrate significant differences between the coronary artery and vein in the smooth muscle properties and in the responses to sympathetic and parasympathetic stimuli.
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Affiliation(s)
- Bowen Wang
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Igelösa Life Science AB, Lund, Sweden
| | - Zhi Qin
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Igelösa Life Science AB, Lund, Sweden
| | - Mei Li
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Igelösa Life Science AB, Lund, Sweden
| | - Anders Arner
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Stig Steen
- Department of Clinical Sciences, Lund University, Lund, Sweden
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Li S, Anwar IJ, Canning AJ, Vo-Dinh T, Kirk AD, Xu H. Xenorecognition and costimulation of porcine endothelium-derived extracellular vesicles in initiating human porcine-specific T cell immune responses. Am J Transplant 2023; 23:904-919. [PMID: 37054891 PMCID: PMC10330644 DOI: 10.1016/j.ajt.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/15/2023]
Abstract
Porcine vascular endothelial cells (PECs) form a mechanistic centerpiece of xenograft rejection. Here, we determined that resting PECs release swine leukocyte antigen class I (SLA-I) but not swine leukocyte antigen class-II DR (SLA-DR) expressing extracellular vesicles (EVs) and investigated whether these EVs proficiently initiate xenoreactive T cell responses via direct xenorecognition and costimulation. Human T cells acquired SLA-I+ EVs with or without direct contact to PECs, and these EVs colocalized with T cell receptors. Although interferon gamma-activated PECs released SLA-DR+ EVs, the binding of SLA-DR+ EVs to T cells was sparse. Human T cells demonstrated low levels of proliferation without direct contact to PECs, but marked T cell proliferation was induced following exposure to EVs. EV-induced proliferation proceeded independent of monocytes/macrophages, suggesting that EVs delivered both a T cell receptor signal and costimulation. Costimulation blockade targeting B7, CD40L, or CD11a significantly reduced T cell proliferation to PEC-derived EVs. These findings indicate that endothelial-derived EVs can directly initiate T cell-mediated immune responses, and suggest that inhibiting the release of SLA-I EVs from organ xenografts has the potential to modify the xenograft rejection. We propose a secondary-direct pathway for T cell activation via xenoantigen recognition/costimulation by endothelial-derived EVs.
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Affiliation(s)
- Shu Li
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Imran J Anwar
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Aidan J Canning
- Department of Biomedical Engineering, Duke University School of Medicine, Durham, North Carolina, USA
| | - Tuan Vo-Dinh
- Department of Biomedical Engineering, Duke University School of Medicine, Durham, North Carolina, USA
| | - Allan D Kirk
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA; Department of Immunology, Duke University School of Medicine, Durham, North Carolina, USA
| | - He Xu
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
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Ma X, Li S, Wang J, Xu C, Wang W. Establishment of a donor pig for xenotransplantation clinical trials based on the principle of Changsha Communiqué. HEALTH CARE SCIENCE 2023; 2:129-134. [PMID: 38938766 PMCID: PMC11080849 DOI: 10.1002/hcs2.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 06/29/2024]
Abstract
Background Xenotransplantation is a potential way to reduce the shortage of the needed organ grafts for the end-stage disease. Immune rejection, physiological incompatibility and bio-safety are the most critical issues. Methods To ensure the safety and efficacy of gene editing, second- and third-generation sequencing technologies have allowed us to obtain a clearer genetic background of donor pigs for xenotransplantation. Based on the Changsha Communiqué, the local DPF- excluded lists and DPF donor facility were established in Changsha, China. A pig-to-human islet clinical trial was conducted and overseen by the respective Chinese governmental agency. Results The DPF standards for pig husbandry eliminated specific pathogens in donor pigs. We have established a PERV-C free, genetic information clean, DPF donor for xenotransplantation. A clinical trial of ten adult patients (9M:1F) with type 1 diabetes who received DPF porcine islet xenotransplantation via the portal vein were performed. Clinical accepted immunosuppressant drugs and autologous Treg were used for controlling immune rejection. No cross-species infection events occurred in this trial, and importantly, no cross-species transmission of PERV was found. Conclusions Xenotransplantation is a pioneer study and safety is the most important issue. The fundamental principles for establishing xenotransplantation donor pigs should follow the Changsha Communiqué (2008), the second WHO consultation,and the 2018 Changsha Communiqué which would finally help reducing the risks of xenotransplantation.
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Affiliation(s)
- Xiaoqian Ma
- Institute for Cell Transplantation and Gene TherapyThe 3rd Xiangya Hospital of Central South UniversityChangshaChina
- Engineering and Technology Research Center for Xenotransplantation of Human ProvinceChangshaChina
| | - Sang Li
- Engineering and Technology Research Center for Xenotransplantation of Human ProvinceChangshaChina
| | - Jia Wang
- Engineering and Technology Research Center for Xenotransplantation of Human ProvinceChangshaChina
| | - Chang Xu
- Engineering and Technology Research Center for Xenotransplantation of Human ProvinceChangshaChina
| | - Wei Wang
- Institute for Cell Transplantation and Gene TherapyThe 3rd Xiangya Hospital of Central South UniversityChangshaChina
- Engineering and Technology Research Center for Xenotransplantation of Human ProvinceChangshaChina
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Ríos A, López-Navas A, Ayala-García MA, Ramírez P. The acceptance of xenotransplantation among African immigrants living in Spain. Cir Esp 2022:S2173-5077(22)00229-0. [PMID: 35777626 DOI: 10.1016/j.cireng.2022.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/26/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante (International Collaborative Donor Project), Murcia, Spain.
| | - Ana López-Navas
- Proyecto Colaborativo Internacional Donante (International Collaborative Donor Project), Murcia, Spain; Departamento de Psicología, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Marco Antonio Ayala-García
- Proyecto Colaborativo Internacional Donante (International Collaborative Donor Project), Murcia, Spain; Hospital Regional General Número 58 del IMSS, Guanajuato, México
| | - Pablo Ramírez
- Proyecto Colaborativo Internacional Donante (International Collaborative Donor Project), Murcia, Spain; Unidad de Trasplantes, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain; Departamento de Cirugía, Pediatría, Obstetricia y Ginecología, Universidad de Murcia, Murcia, Spain
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Wadiwala IJ, Garg P, Yazji JH, Alamouti-fard E, Alomari M, Hussain MWA, Elawady MS, Jacob S. Evolution of Xenotransplantation as an Alternative to Shortage of Donors in Heart Transplantation. Cureus 2022; 14:e26284. [PMID: 35754438 PMCID: PMC9230910 DOI: 10.7759/cureus.26284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 12/03/2022] Open
Abstract
This review aims to show and illustrate the history, current, ethical considerations, and limitations concerning xenotransplantation. Due to the current shortage of available donor organs for transplantation, many alternative sources are being examined to solve the donor shortage. One of them is xenotransplantation which refers to the transplantation of organs from one species to another. Compared to other nonhuman primates (NHP), pigs are ideal species for organ harvesting as they rapidly grow to human size in a handful of months. There is much advancement in the genetic engineering of pigs, which have hearts structurally and functionally similar to the human heart. The role of genetic engineering is to overcome the immune barriers in xenotransplantation and can be used in hyperacute rejection and T cell-mediated rejection. It is technically difficult to use large animal models for orthotopic, life-sustaining heart transplantation. Despite the fact that some religious traditions, such as Jewish and Muslim, prohibit the ingestion of pork products, few religious leaders consider that donating porcine organs is ethical because it saves human life. Although recent technologies have lowered the risk of a xenograft producing a novel virus that causes an epidemic, the risk still exists. It has major implications for the informed consent procedure connected with clinical research on heart xenotransplantation.
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Odonkor P, Strauss E, Williams B. Ethical considerations during a pioneering surgical procedure: porcine cardiac xenotransplantation. Br J Hosp Med (Lond) 2022; 83:1-7. [DOI: 10.12968/hmed.2022.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Preclinical advances in life-sustaining porcine cardiac xenotransplantation from donor pigs to baboons have paved the way for the performance of porcine cardiac xenotransplantation in a human. This procedure was performed with emergency use authorisation granted by the United States Food and Drug Administration under the umbrella of investigational new drug use on compassionate grounds. The patient was denied candidacy for durable mechanical circulatory support and heart transplantation as a result of non-adherence to medical advice. Successful porcine cardiac xenotransplantation in humans will significantly increase the availability of potential donor organs for long-term management of end-stage heart failure. Human porcine cardiac xenotransplantation is associated with ethical conflicts encompassing multiple ethical principles which are not mutually exclusive and are sometimes conflicting. This article focuses on some of the ethical conflicts encountered in relation to the use of mechanical circulatory support, pretransplant evaluation, shared decision making during informed consent, infectious disease risk, preclinical and clinical testing, and the role of regulatory bodies during performance of the first human porcine cardiac xenotransplantation. An increase in human trials of xenotransplantation procedures is imminent. Potential ethical conflicts associated with xenotransplantation should be addressed appropriately.
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Affiliation(s)
- Patrick Odonkor
- Division of Cardiac Anesthesiology, Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Erik Strauss
- Division of Cardiac Anesthesiology, Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Brittney Williams
- Division of Cardiac Anesthesiology, Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
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Ríos A, López-Navas A, Ayala-García MA, Ramírez P. Aceptación del xenotrasplante de órganos entre los inmigrantes africanos residentes en España. Cir Esp 2022. [DOI: 10.1016/j.ciresp.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Smoroda A, Douin D, Morabito J, Lyman M, Prin M, Ahlgren B, Young A, Christensen E, Abrams BA, Weitzel N, Clendenen N. Year in Review 2021: Noteworthy Literature in Cardiothoracic Anesthesia. Semin Cardiothorac Vasc Anesth 2022; 26:107-119. [PMID: 35579926 PMCID: PMC9588253 DOI: 10.1177/10892532221100660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In 2021, progress in clinical science related to Cardiac Anesthesiology continued, but at a slower rate due to the ongoing pandemic and disruptions to clinical research. Most progress was incremental and addressed persistent questions related to our field. To identify articles for this review, we completed a structured review using our previously reported methods (1). Specifically, we used the search terms: "cardiac anesthesiology and outcomes" (n = 177), "cardiothoracic anesthesiology" (n = 34), "cardiac anesthesia," and "clinical outcomes" (n = 42) filtered on clinical trials and the year 2021 in PubMed. We also reviewed clinical trials from the most prominent clinical journals to identify additional studies for a narrative review. We then selected the most noteworthy publications for inclusion in this review and identified key themes.
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Affiliation(s)
- Aaron Smoroda
- University of Colorado School of Medicine, Aurora, CO, USA
| | - David Douin
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Joseph Morabito
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew Lyman
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Meghan Prin
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Bryan Ahlgren
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Andrew Young
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Benjamin A Abrams
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nathaen Weitzel
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nathan Clendenen
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Affiliation(s)
- Joanna Chikwe
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
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