Thursday October 10, 2019 from 13:40 to 15:10
Clinical xenotransplantation poses many of the same infectious challenges posed by allotransplantation, reflecting the immunosuppression required to maintain graft function. The risk for infection is a function of epidemiological exposures from the environment and the transplanted organ as well as from the recipient. In allotransplantation, microbiological screening of organ donors, prophylactic antimicrobial therapies, and monitoring of recipients for common infections have dramatically improved outcomes. Immunosuppression in xenotransplantation from swine will depend on similar approaches. Xenotransplantation also poses a unique opportunity and hurdle – there are more limited data on the microbiology of swine coupled with the opportunity to screen more intensively than is feasible for human donors. Organisms of swine thought to pose a risk for the immunosuppressed host or other unique microbes (e.g., porcine endogenous retroviruses or porcine cytomegalovirus) may be excluded from donors or monitored in recipients. Novel monitoring strategies may supplement pathogen-specific assays using advanced sequencing modalities. Protocols for the management of the “infected recipient” can be developed to further enhance clinical safety.