Expert opinion on the identification, risk assessment, and mitigation of microorganisms and parasites relevant to xenotransplantation products from pigs

© 2023 BioPolicy Solutions, LLC. EpiX Analytics. et al and The Authors. Xenotransplantation published by John Wiley & Sons Ltd..

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 porcine MP (due to their pathogenic potential, n = 130); non-disqualifying porcine MP (still relevant to consider for biosecurity or monitoring efforts, n = 40); and alert/watch list (not reported in the USA or MP 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.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:30

Enthalten in:

Xenotransplantation - 30(2023), 5 vom: 01. Sept., Seite e12815

Sprache:

Englisch

Beteiligte Personen:

Groenendaal, Huybert [VerfasserIn]
Costard, Solenne [VerfasserIn]
Ballard, Reid [VerfasserIn]
Bienhoff, Stephen [VerfasserIn]
Challen, Diana C [VerfasserIn]
Dominguez, Brandon J [VerfasserIn]
Kern, Douglas R [VerfasserIn]
Miller, Dan [VerfasserIn]
Noordergraaf, Jeske [VerfasserIn]
Rudenko, Larisa [VerfasserIn]
Schuurman, Henk-Jan [VerfasserIn]
Spizzo, Tom [VerfasserIn]
Sturos, Matthew [VerfasserIn]
Zollers, Bill [VerfasserIn]
Fishman, Jay A [VerfasserIn]

Links:

Volltext

Themen:

Hazard identification
Human health
Journal Article
Pig
Porcine microorganisms
Porcine parasites
Risk assessment
Risk management
Xenotransplantation

Anmerkungen:

Date Completed 02.11.2023

Date Revised 02.11.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/xen.12815

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM361145527