How could xenotransplantation be made into a routine practice?
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Jamila Aug 12, 2020
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What would be required to make xenotransplants fit for routine practice?
There is a substantial shortage of organs available around the world. There are approximately thousands of individuals waiting for an organ transplant in the UK and hundreds of thousands of people are waiting for a transplant in the US. Unfortunately, many of those on the transplant waiting list will succumb due to these organ shortages. In order to tackle this problem, xenotransplantation has been proposed. Xenotransplantation is whereby animal organs are transplanted into human patients. This may be viable as there are some animal organs that are similar to human organs in terms of size. However, animal organs would need to be made compatible with humans and the risk of infection needs to be minimized.
Would xenotransplantation be more likely to be used if the animal organs were made compatible and the viral capabilities were removed? and how could this be achieved?
[1]Ekser, Burcin, Ping Li, and David KC Cooper. "Xenotransplantation: past, present, and future." Current opinion in organ transplantation 22.6 (2017): 513.
There are certain steps we can take to minimize the risk of viral capabilities during xenotransplantation. Potential viruses need to be screened for before organ transplantation, since transplantation increases the risk of 'species jumping' of viruses. The list of tests available for known viruses should be constantly updated, and the sensitivity and specificity of the diagnostic tests should be maximized. Before transplantation, the donor animal should be tested using both PCR and serologic assays. Research to detect unknown viruses should be promoted.
Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1189617/pdf/cjvetres00008-0003.pdf
"Porcine endogenous retroviruses (PERVs) are integrated into the porcine genome with multiple copies and the number of PERV proviruses varies among pig breeds and organs, ranging from 1 to more than 100." Therefore, a gene assay should also be conducted of the donor animal to check for viral genes.
Reference: https://www.frontiersin.org/articles/10.3389/fimmu.2019.03060/full
Finally, I direct you to a recent technique called "blastocyst complementation" that is used for organ generation for xenotransplantation. I did not come across any study that specifically checked for viral capabilities associated with blastocyst complementation. But this is a unique method of organ generation and may probably minimize its risk.
Reference: Comment on the suggestion "Combining existing technologies to overcome problems with organ regeneration" - https://brainstorming.com/sessions/why-are-embryonic-stem-cell-lines-genetically-different-from-the-person-they-are-taken-from/41
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