2023-이종장기이식에 대한 전문가의견(AJT)
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작성자 신호식 작성일23-09-02 09:24 조회347회 댓글0건첨부파일
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Xenotransplantation has the potential to address shortages of organs available for
clinical transplantation, but concerns exist regarding potential risks posed by porcine
microorganisms and parasites (MP) to the health of human recipients. In this study,
a risk-based framework was developed, and expert opinion was elicited to evaluate
porcine MP based on swine exposure and risk to human health. Experts identified 255
MP to include in the risk assessment. These were rated by experts for five criteria
regarding potential swine exposure in the USA and human health risks.MP were subsequently
categorized into three risk mitigation groups according to pre-defined rules:
disqualifying porcineMP(due to their pathogenic potential, n=130); non-disqualifying
porcineMP(still relevant to consider for biosecurity or monitoring efforts, n=40); and
alert/watch list (not reported in the USA orMP not in swine, n=85).Most disqualifying
(n = 126) and non-disqualifying (n = 36) porcine MP can effectively be eliminated with high biosecurity programs. This approach supports surveillance and risk mitigation
strategies for porcine MP in swine produced for xenotransplantation, such as documentation
of freedom from porcine MP, or use of porcine MP screening, monitoring,
or elimination options. To the authors’ knowledge, this is the first effort to comprehensively
identify all relevant porcine MP systematically and transparently evaluate the
risk of infection of both donor animals and immunosuppressed human recipients, and
the potential health impacts for immunosuppressed human recipients from infected
xenotransplantation products from pigs.