Cardiac xenotransplantation in Germany. From consensus to clinical aspects

One of the greatest problems of German transplantation medicine is the striking lack of organs. In particular, donor hearts are in short supply and many seriously ill patients die while on the waiting list for a new heart. In addition to allogeneic transplantation, alternative treatment options for terminal heart failure include implantation of a ventricular support system, which, however, is associated with serious complications in the long term and is not suitable for every patient. Therefore, especially in this area, the transplantation of xenogeneic organs, in this case of genetically modified pigs, is increasingly being brought into the focus of science. In March 2023 a meeting on the topic of "cardiac xenotransplantation" took place, which was attended by representatives of numerous transplantation centers in Germany. This article provides an overview of all the topics debated, including the necessary preclinical preparations, the indications, the limitations, as well as the applicable regulations.