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China Swine Industry
2025, 20 (2):
5-14.
DOI: 10.16174/j.issn.1673-4645.2025.03.001
Xenotransplantation had attracted much attention as a potential solution to the global organ shortage problem, with gene-edited pigs receiving even more attention as a source of donors. In contrasted to the numerous challenges faced in traditional or gan transplantation, when porcine organs were transplanted into humans, they primarily encounter issued such as immune rejection, coagulation dysfunction, and organ size mismatch. Gene-editing technologies like CRISPR/Cas9 could precisely target relevant gene loci in pigs, enabling targeted improvements in aspects such as the knockout of immunogenic antigens (e.g., knockout of the GGTA1 gene), inhibition of complement activation (e.g., inhibition of the β2M gene), regulation of coagulation function (e.g., regulation of the vWF gene), and control of organ growth (e.g., control of the GHR gene), thereby specifically addressing the problems associated with porcine organ transplantation. Additionally, the introduction of human transgenes(e.g., the hCD47 gene) could further enhance the immune toler ance of porcine organs. Globally, multiple subclinical and clinical studied on the transplantation of genetically edited pig kidneys and livers into humans had been successfully conducted, yielding remarkable progress. However, due to the wide variety of gene-editing tools, there were differences in their mechanisms of action and safety, presenting certain technical and safety thresholds. Therefore, this paper systematically summarized the key genes that need to be edited in donor pigs for xenotransplantation that had entered subclinical and clinical trials and the specific editing methods. It also explored and analyzed the safety and efficiency issues of gene-editing tools, as well as the current opportunities and challenges. On the premise of ensuring the safety and effectiveness of gene editing, this paper aimed to provide some references for optimizing relevant gene-editing methods and promoting subsequent research, so as to advance xenotransplantation technology to a new level.
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