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TRANSPLANTATION

A model of pig-to-human kidney transplantation

Nature Reviews Nephrology volume 18, page 199 (2022)Cite this article

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Kidney transplantation improves the survival and quality of life of individuals with kidney failure; however, the numbers of available organs are insufficient to meet demand. Now, researchers describe the outcomes of a safety and feasibility study involving the transplantation of kidneys from a genetically modified pig into a brain-dead recipient. “The promise for the future is tremendous and our study demonstrates several notable firsts,” says Jayme Locke. “Importantly, we demonstrate how pig-to-human transplantation can be implemented in a safe and systematic fashion with potential to help thousands, rather than just one specific individual.”

To establish their model, the researchers obtained informed consent to transplant a 57-year-old brain-dead man with kidneys from a genetically modified pig, harbouring a number of mutations to aid immunocompatibility. Bilateral native nephrectomies were performed to establish anuria in the decedent, after which the pig kidneys were transplanted and a conventional immunosuppressive regimen initiated. “In essence, we replicated every single step of the transplant process and demonstrated feasibility using a pig donor source,” explains Locke. “In the remaining 3 days of the study, we demonstrated that the pig vasculature could withstand human arterial blood pressure and that no transmission of pig endogenous retroviruses occurred,” she adds. The researchers recorded robust urine output from one of the transplanted kidneys; however, creatinine clearance did not recover. “We also developed and tested a pig-to-human specific flow cytometry crossmatch assay that determined tissue compatibility prior to transplantation,” says Locke. “It is of note that pre-transplantation crossmatch testing is a regulatory requirement in the US for human-to-human transplantation.”

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  1. Nature Reviews Nephrology http://www.nature.com/nrneph

    Susan J. Allison

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  1. Susan J. Allison
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Correspondence to Susan J. Allison.

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Allison, S.J. A model of pig-to-human kidney transplantation. Nat Rev Nephrol 18, 199 (2022). https://doi.org/10.1038/s41581-022-00550-7

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