Historically, xenotransplantation from animals to humans was attempted in the 1900s, preceding allogeneic transplantation between humans. Until the establishment of the concept of brain death, allogeneic transplantation could only be performed from donors after circulatory death or living donors. In the 1960s, xenotransplantation from primates to humans was performed, but there were no successful cases. However, along with the elucidation of the mechanisms for xenograft rejection and establishment of nuclear transfer in bioengineering started a boom of the development of transgenic pig donors for xenotransplantation. However, the boom ended after a few years because multiple gene modification was not possible at that time. After the multiple transgene technique was developed, long-term survival cases are being reported in orthotopic heart transplantation from pigs to primates. Eventually, in January 2022, heart transplantation of genetically modified pigs to humans were performed. Here, the author reviews the history of xenotransplantation and discusses the present case, introducing the author’s research experience with xenotransplantation using primates.
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