Year: 2025
Type: article
Abstract: Kidney allotransplantation remains the preferred treatment for end-stage kidney disease, yet donor shortages limit its availability. Xenotransplantation using genetically modified porcine kidneys offers a promising alternative. Here, we report key physiological observations from the first-in-human porcine kidney xenograft over a 51 day postoperative follow-up period. The transplanted kidney maintained essential functions, including waste excretion, electrolyte regulation, and production of concentrated urine, while supporting blood pressure and sodium reabsorption despite reduced activation of the renin-angiotensin-aldosterone system. Sodium retention required diuretic therapy, and mild hypocalcemia and hyperphosphatemia occurred in the setting of pre-existing hypoparathyroidism. Markedly increased urinary uric acid excretion led to hypouricemia without evidence of urate nephropathy. This case demonstrates the ability of a porcine kidney to sustain vital metabolic functions in a living human, while highlighting areas for further research. These findings provide a foundation for optimizing post-transplant care and advancing xenotransplantation as a solution to the critical organ shortage. Kidney shortages limit treatment options for patients with end-stage kidney disease, prompting exploration of xenotransplantation. Here, the authors show that a genetically modified pig kidney sustained essential functions in a living human for 51 days, informing future clinical strategies.
Source: Nature Communications
Authors: Sul A Lee, Marie-Camille Lafargue, Winfred W. Williams, Kassem Safa, Ragnar Palsson, Ayman Al Jurdi, Abraham Cohen-Bucay, Pitchaphon Nissaisorakarn, Hannah Gilligan, Harald Jüeppner, Leela Morena, Thiago J. Borges, Mariesa A. Le, Kayla F. Joyal, Eugene P. Rhee, Ivy Rosales, Thomas Brannon, Jan Wysocki, Daniel Batlle, Tatsuo Kawai, Leonardo V. Riella
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $6,990
Funders: U.S. Department of Health and Human Services, Massachusetts General Hospital, Alexion Pharmaceuticals, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases
OpenAlex ID: W4414556892