Organ Transplantation 2026;17(1):28-35

doi:10.12464/j.issn.1674-7445.2025252

Research progress and clinical challenges in immunosuppressive regimens for xenotransplantation

Yu ZHANG 1 ; Kun WANG 1 ; Xuyuan ZHU 1 ; Yuxiang CHEN 2 ; Tao LI 2 ; Xiaojie MA 2 ; Hongtao JIANG 1

Affiliations

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Keywords

Xenotransplantation; Rejection; Infection; Gene modification; Immunosuppression; Immune induction；Immune tolerance; Immune-checkpoint inhibitor; Gene therapy

Country

China

Language

Chinese

Abstract

As a pivotal strategy to alleviate the shortage of organ donors, xenotransplantation has achieved remarkable advances in both pre-clinical and clinical studies in recent years, driven by continuous optimization of gene modification techniques and immunosuppressive regimens. Nevertheless, clinical translation still confronts formidable challenges, including rejection and heightened infection risks, which severely compromise long-term graft survival. Consequently, the role of immunosuppressive regimens in xenotransplantation has become increasingly prominent. This article summarizes the mechanisms underlying xenogeneic immune rejection, the latest developments in immunosuppressive regimens, cutting-edge strategies for inducing immune tolerance and the major hurdles facing clinical xenotransplantation. It delves into potential optimization strategies and directions for future clinical research, aiming to offer theoretical insights and practical guidance for the safe and effective application of clinical xenotransplantation.