Porcine to Human Heart Transplantation: Is Clinical Application Now Appropriate?

Table 1

The longest (median) reported heterotopic cardiac xenograft survival as a function of donor genetics and immune suppression.

Donor	Earlier immune suppression		Costimulation blockade
	CsA/CyP/steroid	ATG/CD20/tacrolimus/sirolimus	ATG/LoCD2b/CVF/anti-CD154/MMF	ATG/anti-CD40, CD20/CVF/MMF
WT	32^§ (21 d) [27]; 25^‡ (12 d) [28]	n.r.	n.r.	n.r.
WT;hCRP	99^Δ (26 d) [29]; 78^Δ (35 d) [30]	109^#† (20 d) [31]; 137^#† (96 d) [32]	139 (27 d) [36]	n.r.
GTKO	n.r.	128^† (22 d) [34]	179 (78 d) [37]	n.r.
GTKO;hCRP	n.r.	52^∇† (28 d) [34]	8^¶ (8 d) 236^†¶ (71 d) [5]	149^¶ (84 d) [25]
GTKO;hCRP;TBM	n.r.	n.r.	n.r.	945^¶ (298 d) [8]

n.r.: none reported. ^§Soluble CR1 to block complement activation. ^‡Cobra venom factor at 0.25–0.5 mg/kg prior to surgery and 0.1–0.5 mg/kg every 1–4 days thereafter. Included use of alpha-Gal polymer GAS914 [127] or Nex1285 [128]. ^†Immune suppression included anti-CD20 (Rituximab) B-cell depletion. ^ΔhDAF (human CD55) minigene [129]. ^∇A murine H-2Kb regulated human CD55 transgene [77]. ^#hCD46 transgene based on 60 kb human genomic CD46 DNA [130]. ^¶hCD46 transgene based on a human CD46 minigene [131].