Xenotransplantation of a Porcine Kidney for End-Stage Kidney Disease
Xenotransplantation offers a potential solution to the organ shortage crisis. A 62-year-old hemodialysis-dependent man with long-standing diabetes, advanced vasculopathy, and marked dialysis-access challenges received a gene-edited porcine kidney with 69 genomic edits, including deletion of three glycan antigens, inactivation of porcine endogenous retroviruses, and insertion of seven human transgenes. The xenograft functioned immediately. The patient's creatinine levels decreased promptly and progressively, and dialysis was no longer needed. After a T-cell-mediated rejection episode on day 8, intensified immunosuppression reversed rejection. Despite sustained kidney function, the patient died from unexpected, sudden cardiac causes on day 52; autopsy revealed severe coronary artery disease and ventricular scarring without evident xenograft rejection. (Funded by Massachusetts General Hospital and eGenesis.).
Authors
- Claire Avillach
- Thiago J. Borges (ORCID: https://orcid.org/0000-0002-6554-0169)
- Winfred W. Williams (ORCID: https://orcid.org/0000-0001-9984-7102)
- Tatsuo Kawai (ORCID: https://orcid.org/0000-0002-6900-4603)
- Ivy A. Rosales (ORCID: https://orcid.org/0000-0003-0621-3202)
- Nahel Elias (ORCID: https://orcid.org/0000-0001-6466-7347)
- Ahmad Karadagi (ORCID: https://orcid.org/0000-0002-1360-938X)
- Robert B. Colvin (ORCID: https://orcid.org/0000-0002-4493-4150)
- Jay A. Fishman (ORCID: https://orcid.org/0000-0002-2671-3311)
- Tsukasa Nakamura
- Eva Patalas (ORCID: https://orcid.org/0000-0003-1541-0320)
- Wenning Qin (ORCID: https://orcid.org/0000-0001-9168-5102)
- Toshihide Tomosugi (ORCID: https://orcid.org/0000-0001-8715-9134)
- Steve Perrin
- Alessia Giarraputo (ORCID: https://orcid.org/0000-0003-4070-7943)
- William T. Serkin (ORCID: https://orcid.org/0000-0001-8551-5035)
- Alban Longchamp (ORCID: https://orcid.org/0000-0002-1743-4935)
- Shoko Kimura (ORCID: https://orcid.org/0000-0001-5250-9448)
- Leela Morená (ORCID: https://orcid.org/0000-0001-8295-1026)
- R. Anand (ORCID: https://orcid.org/0000-0001-7389-391X)
- Michael W. Duggan (ORCID: https://orcid.org/0000-0002-6431-6827)
- Sagar Chhangawala (ORCID: https://orcid.org/0000-0001-9626-1034)
- A. Benedict Cosimi
- Kristen Getchell (ORCID: https://orcid.org/0000-0002-4064-2636)
- Kassem Safa (ORCID: https://orcid.org/0000-0001-6447-3227)
- Owen Pearce
- Michael A. Curtis (ORCID: https://orcid.org/0000-0002-1563-9953)
- Leonardo V. Riella (ORCID: https://orcid.org/0000-0002-7636-3196)
- Joren C. Madsen (ORCID: https://orcid.org/0000-0003-2724-1333)
- Kerry Crisalli
- Feng Li
- David H. Sachs
- Ming Wai Yeung (ORCID: https://orcid.org/0000-0001-9794-3109)
- Richard N. Pierson
- R. Neal Smith
- Susan C. Low
- David K.C. Cooper
- Matthew Coscarella
- Alexandre Daigneault
Institutions
- Harvard University (US)
- Massachusetts General Hospital (US)
- Genesis Foundation (US)
Publication Details
- Journal
- New England Journal of Medicine
- Published
- 2025-02-07
- DOI
- https://doi.org/10.1056/nejmoa2412747
- Citations
- 105
- Primary Topic
- Xenotransplantation and immune response
- Type
- article
- Field-Weighted Citation Impact
- 210.68