Cardiac Xenotransplantation: Current State and Future Directions

Increasing demand for donor hearts in cardiac transplantation has spurred interest in xenotransplantation aided by advancements in immunosuppression and genetic engineering. Clinical trials of genetically modified pig hearts have seen two patients survive 40 and 60 days before graft failure. Research is now focusing on assessing xenografts in brain-dead recipients. Despite progress, challenges such as adaptive immune responses remain. Recent xenotransplantations at the University of Maryland mark important advancements, offering a promising solution to the growing organ donor shortage. This review offers a comprehensive evaluation of the recent advances, persistent challenges, and future potential of cardiac xenotransplantation, with an emphasis on translating preclinical innovations into clinical practice.