Work

Bridging the Gap: Assessing Knowledge, Preparedness, and Regulatory Perspectives on Genetically Engineered Pig-to-Human Xenotransplants Among Transplant Specialists

Year: 2025

Type: article

Abstract: Purpose:With advancements in genetically engineered pig-to-human xenotransplant (GEPHXT), we aim to assess knowledge gaps, perceptions, and preparedness for GEPHXT among survey respondents.Methods: A cross-sectional survey was administered in February 2025 via AST KPCOP Hub, online chat groups, and direct emails for transplant physicians and surgeons within the United States and internationally.The survey evaluated demographics, knowledge, perceptions toward GEPHXT, preparedness, and opinions on regulatory requirements.Descriptive statistics, Spearman's rank correlations assessed relationships between variables and ordered logistic regression evaluated associations between demographic factors and key outcomes.Results: Respondents (n=111) were predominantly male (64.2%), clinicians (68.2%), transplant nephrologists (87.0%).Despite 74.8% supporting GEPHXT, self-perception of scientifi c knowledge varied; 57% reported little or no knowledge, while only 4.5% considered themselves extremely knowledgeable, and only 9.0% felt well-prepared to discuss xenotransplantation.Self-described knowledge level positively correlated with perceptions of preparedness to discuss xenotransplantation (p<0.0001).Surprisingly, years of experience did not signifi cantly correlate with support for xenotransplantation (p = 0.7593).Respondents identifi ed long-term monitoring (80.2%) and clinical trial transparency (77.5%) as critical regulatory challenges, with 72.8% indicating that 3-5 years of safety data would be necessary before widespread implementation.Key patient selection criteria included willingness to receive GEPHXT (82.0%) and lack of alternative treatment options (77.5%).Respondents were evenly divided as to whether additional studies in decedents were needed (52.8% yes, 47.2% no or no opinion).Only 3.6% feel very knowledgeable about CRISPR-Cas9, the primary technology enabling GEPHXT.Conclusions: The survey highlights a strong enthusiasm for xenotransplantation but exposes significant gaps in knowledge and preparedness among kidney transplant clinicians.It underscores the importance of targeted education to improve understanding of technologies like CRISPR-Cas9 and the regulatory landscape, which may increase preparedness and ensure ethical implementation.

Source: American Journal of Transplantation

DOI: 10.1016/j.ajt.2025.07.434