Consistent survival in consecutive cases of life-supporting porcine kidney xenotransplantation using 10GE source pigs

Xenotransplantation represents a possible solution to the organ shortage crisis and is an imminent clinical reality with long-term xenograft survival in pig-to-nonhuman primate (NHP) heart and kidney models and short-term success in human decedent and clinical studies. Concerns remain about clinical translation given inconsistency in survival, differences between preclinical procurement/preservation and clinical standards, and reliance on non–FDA-approved CD40/CD154 costimulatory blockade. We present consistent survival in consecutive pig-to-NHP kidney xenotransplantations, including long-term survival after more than 3 hours of cold preservation and long-term survival using only FDA-approved immunosuppression. These data support the safety and feasibility of clinical kidney xenotransplantation and suggest that long-term survival without CD40/CD154 blockade can inform immunosuppression regimens for first-in-human trials.