Kidney Week 2025 Early Program - Care of Kidney Transplant Candidates and Recipients-Updates in Xenotransplantation

Video Transcription

Video Summary

Dr. Vanita Kumar (UAB) reviewed key updates in kidney xenotransplantation, framed around what clinicians should tell patients. Three “ready-to-go” genetically edited porcine kidney products exist, and three FDA-approved clinical trials are now underway (United Therapeutics’ 10-gene and 1-gene+thymus constructs, and eGenesis’ 69-gene edit). Early human experience suggests a single pig kidney may provide an eGFR around 40–50 mL/min, with generally stable electrolytes and acid excretion, but persistent hyperphosphatemia and consistent near-nephrotic proteinuria remain unexplained. Pig EPO is ineffective in humans, so recipients likely need supplementation; pig renin may not fully support human RAAS. Xenografts appear to require heavier immunosuppression than allotransplants (including costimulation blockade and complement inhibition), and optimal crossmatching methods are still being defined. Infection monitoring is central, highlighted by prior porcine CMV transmission issues and the need for lifelong xenozoonotic surveillance, raising ethical concerns affecting recipients and families.

Asset Subtitle

Vineeta Kumar

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Module TRX

Speaker Vineeta Kumar

Keywords

kidney xenotransplantation

genetically edited porcine kidney

FDA-approved clinical trials

immunosuppression and complement inhibition

xenozoonotic infection surveillance