Current state of clinical trials on xenograft.

BACKGROUND: Xenotransplantation is a worth investing branch of science, since it aims to fulfil the demand on human cells, tissues and organs. Despite decades of consistent work in preclinical assessments, clinical trials on xenotransplantation are far from reaching the targeted goal. Our study aims to track the characteristics, assess the content and summarize the plan of each trial on skin, beta-island, bone marrow, aortic valve and kidney xenografts, leading to a clear sorting of efforts made in this field. METHODS: In December 2022, we searched clinicaltrial.gov for interventional clinical trials related to xenograft of skin, pancreas, bone marrow, aortic valve and kidney. A total of 14 clinical trials are included in this study. Characteristics on each trial were gathered. Linked publications were searched using Medline/PubMed and Embase/Scopus. Content of trials was reviewed and summarized. RESULTS: Only 14 clinical trials met our study's criteria. The majority were completed, and most of the trials' enrolment was between 11 and 50 participants. Nine trials used a xenograft of porcine origin. Six trials targeted skin xenotransplantation, four targeted ß-cells, two targeted bone marrow and one trial targeted each of the kidney and aortic valve. The average length of trials was 3.38 years. Four trials were conducted in the United States and two trials in each of Brazil, Argentina and Sweden. Of all the included trials, none had any results provided and only three had published work. Phases I, III, and IV had only one trial each. A total of 501 participants were enrolled in these trials. CONCLUSION: This study sheds the light on the current state of clinical trials on xenograft. Characteristically, trials on this field are of low number, low enrolment, short duration, few related publications and no published results. Porcine organs are the most used in these trials, and skin is the most studied organ. An extension of the literature is highly needed due to the variety of conflicts mentioned. Overall, this study sheds the light on the necessity of managing research efforts, leading to the initiation of more trials targeting the field of xenotransplantation.

Never seen right gastrothorax: A case report.

Traumatic gastrothorax, or stomach herniation into the chest post-trauma, is a rare but dangerous condition that can lead to respiratory distress and obstructive shock. Its diagnosis is challenging and requires a high index of suspicion. Immediate stomach decompression is an important, often life-saving step of the treatment, prior to definitive surgical repair. We report herein the case of a 59 year-old female patient, who was involved in a severe motor vehicle accident resulting in multiple injuries. Her right-sided gastrothorax, manifesting as solely nausea at first, was only diagnosed 16 days after trauma, intraoperatively. Worse, her herniated stomach had ruptured within the right pleural cavity causing pneumothorax, spillage of contents and pleuritis. It was an erroneous radiological diagnosis of right lung necrosis which halted surgical management. Right gastrothorax has never been reported previously. This article also reviews the condition's pathophysiology, along with diagnostic and therapeutic modalities, and sheds light on the importance of its early recognition and treatment.