Clinical Heart Xenotransplantation: A Beat or Two Away?

Purpose of Review: This manuscript aims to examine key scientific milestones leading to human decedent studies and the compassionate use of cardiac xenografts in human recipients. It also evaluates the peri-operative considerations necessary before initiating large-scale clinical trials. Recent Findings: The early functionality of cardiac xenografts in humans was initially demonstrated in two brain-dead human decedents through the transplantation of 10-gene-edited hearts from porcine donors. Subsequently, two living human patients received heart xenografts from similarly constructed pigs. Although both patients developed diastolic heart failure and subsequently lost xenograft function, significant insights were gained regarding patterns of immune rejection and strategies to prevent similar outcomes in the future. Summary: This review consolidates findings from pre-clinical (non-human primate and decedent) and initial human cardiac xenotransplant studies, emphasizing the peri-operative considerations required before proceeding with clinical trials.