{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:57:48Z","timestamp":1792461468152,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Xenotransplantation"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Since January 2022, eleven clinical xenotransplants into living patients involving gene\u2010edited pig hearts (\n                    <jats:italic>n<\/jats:italic>\n                    = 2) or kidneys (\n                    <jats:italic>n<\/jats:italic>\n                    = 9) have provided initial data on patient selection, organ sourcing, and immunosuppression. Lessons from cardiac cases indicate that (i) patient selection must prioritize candidates with a realistic recovery potential from preexisting debility, (ii) immunosuppressive regimens should be initiated 5\u20137 days pretransplant to ensure therapeutic blood levels, (iii) the administration of products that potentially contain anti\u2010pig antibodies should be avoided, and (iv) highly sensitive assays are essential to ensure the graft is free of pathogenic microorganisms. In renal cases, evidence suggests that (i) pig organs with multiple gene edits may provide superior protection against the human immune response, and (ii) while immunosuppression targeting the CD40\/CD154 co\u2010stimulation pathway effectively prevents the adaptive immune response, it currently fails to eliminate the development of thrombotic microangiopathy or proteinuria. It remains to be determined whether the current gene editing and immunosuppressive protocols are sufficient to enable truly long\u2010term survival of patients and grafts.\n                  <\/jats:p>","DOI":"10.1111\/xen.70147","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T10:35:21Z","timestamp":1783161321000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical Pig Organ Transplantation: What Have We Learned So Far?"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8899-9431","authenticated-orcid":false,"given":"David K. C.","family":"Cooper","sequence":"first","affiliation":[{"name":"Center For Transplantation Sciences Department of Surgery Massachusetts General Hospital\/Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4179-7365","authenticated-orcid":false,"given":"Hidetaka","family":"Hara","sequence":"additional","affiliation":[{"name":"The Transplantation Institute of the Second Affiliated Hospital Hainan Medical University  Haikou Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuhui","family":"Pu","sequence":"additional","affiliation":[{"name":"Imaging Department The First Affiliated Hospital of Shenzhen University Shenzhen Second People's Hospital  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6232-8341","authenticated-orcid":false,"given":"Lisha","family":"Mou","sequence":"additional","affiliation":[{"name":"Shenzhen Xenotransplantation Medical Engineering Research and Development Center Shenzhen Institute of Translational Medicine Health Science Center The First Affiliated Hospital of Shenzhen University Shenzhen Second People's Hospital  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2022.12.023"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2025.08.044"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010023\u201006594\u20104"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/xen.12516"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890\u2010200006150\u201000013"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.861471"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/xen.12161"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/xen.12711"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004458"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004996"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16780"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000005508"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","unstructured":"J. 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B.Mitchell W.Swicord et\u00a0al. \u201cGene\u2010Edited Pig Cardiac Xenotransplantation as a Bridge to Allotransplantation in Infants: Progress in a Pig\u2010to\u2010Baboon Model \u201dAmerican Journal of TransplantationS1600\u20106135 no.25(2025): 03182\u2013X https:\/\/doi.org\/10.1016\/j.ajt.2025.12.017.","DOI":"10.1016\/j.ajt.2025.12.017"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/xen.12167"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002796"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.111.247684"},{"key":"e_1_2_8_18_1","unstructured":"U.S. Food and Drug Administration Center for Biologics Evaluation and Research. \u201cSource Animal Product Preclinical and Clinical Issues Concerning the use of Xenotransplantation Products in Humans \u201d published April 22 2024 https:\/\/www.fda.gov\/regulatory\u2010information\/search\u2010fda\u2010guidance\u2010documents\/source\u2010animal\u2010product\u2010preclinical\u2010and\u2010clinical\u2010issues\u2010concerning\u2010use\u2010xenotransplantation\u2010products."},{"key":"e_1_2_8_19_1","unstructured":"U.S. Food and Drug Administration Center for Biologics Evaluation and Research. \u201cPHS Guideline on Infectious Disease Issues in Xenotransplantation \u201d published June 21 2024 https:\/\/www.fda.gov\/regulatory\u2010information\/search\u2010fda\u2010guidance\u2010documents\/phs\u2010guideline\u2010infectious\u2010disease\u2010issues\u2010xenotransplantation."},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.05.010"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm1171"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm1172"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.12.020"},{"issue":"48","key":"e_1_2_8_24_1","first-page":"1271","article-title":"The Operation. 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