Immunosuppression that generally depresses the immune system causes risk to transplant recipients.
With higher volumes and decreased donor variability it will be technically feasible and financially attractive to create immunosuppressives that target only the anti-xenograft immune response.
The synergism of reduced risk will help to propel further growth in xenotransplantation.
Currently, xenotransplantation is enabled by newer immunosuppressive medications called costimulatory blockades. This is augmented with antibody therapy used during the induction stage similar to that used in allotransplantation.
These agents generally depress the immune system and are not specific to those donor antigens at the root of graft rejection.
With increased volume and the reduction in variability of the donor genotype in the inbred pig, we expect that agents specific to the donor will be generated, thus avoiding the complications involved with the overall suppression of today’s immunosuppression cocktails.
Non-donor specific immunosuppression has been a bane in transplantation. Infectious complications and malignancies are directly related to the broad immuno-depressing immunosuppression currently available. Due to the genetic variation of human donors, the non-self elements targeted can vary case to case, making immunosuppression targeted to these differences impractical.
The genetic variability of a xenograft donor is highly controlled. Essentially, these pigs are more like twins than siblings or cousins standardizing the potential targets of rejection from the recipient. Existing technologies, including targeted antibody therapy and IgG‐degrading enzymes such as imlifidase can be adapted to be antigen specific and the entire field of nanotechnology/biology can be brought to bear on a fixed set of xenograft target antigens.
Additionally, with the organ shortage resolved by xenotransplantation, the number of transplants done will skyrocket, making antigen-specific immunosuppressants an attractive market.