FIGURE 1.

Strategy to overcome acute pulmonary xenograft dysfunction. The large surface area of pulmonary vascular and alveolar endothelium is thought to be a particularly susceptible target to injury following xeno lung transplantation. Endothelial cell injury after xeno lung transplantation results from severe inflammatory or coagulation dysregulation, which are amplified by the incompatibility between pig and human inflammation/coagulation cascade regulatory proteins, as well as high levels of procoagulant vWF or proinflammatory pulmonary intravascular macrophages. This ultimately leads to rapid xenogenic lung dysfunction. Several approaches including the use of genetically modified pig lungs, along with pharmaceutical therapies, have been shown to prevent rapid lung xenograft dysfunction.