Xenotransplantation: A Kidney Transplant Research Possibility

Kidney transplantation is the best available treatment for kidney failure. However, there are not enough human donor kidneys for all the people who need them.

Researchers are exploring the possibility of xenotransplantation as a potential future treatment for kidney failure. Xenotransplantation is the transplantation of organs, tissue, or cells from one species to another.

In collaboration with the American Society of Nephrology's Kidney Health Initiative, in April and May 2022, AIR experts conducted one-hour virtual, individual interviews with a diverse, purposive sample of 20 adults with kidney failure who were either receiving a form of dialysis or living with a kidney transplant, 10 care partners, and nine nephrologists.

In this brief, we share findings related to participants’ awareness of xenotransplantation as a potential future kidney transplant option in light of recent advancements. We also discuss what the participants perceived as the benefits and risks of xenotransplantation as well as their recommendations for when and how patients, families, and clinicians should have discussions about xenotransplantation, and what information is most important to share. 
 

Key Findings

• Patients, care partners, and nephrologists shared several perceived benefits of xenotransplantation, including expanding the supply of organs available, reducing long waiting times, and potentially providing a bridge therapy for patients who do not want to start dialysis or who experience a rejection event, for example. Perceived risks included organ rejection, infection, or other complications. 
• Nephrologists also identified the unknowns associated with xenotransplantation as posing risks because there is little data available related to short-and long-term outcomes that would better indicate the safety of this form of transplant. 
• Patients, care partners, and nephrologists expressed a need for transparent and understandable information about xenotransplantation that is accessible and understandable for diverse audiences. 
• Most people with kidney failure and their care partners felt that the nephrologist should share information about xenotransplantation with patients and families. Nephrologists stated that they would first want more education for themselves about xenotransplantation and clinical trials before sharing such information. 
• Patients, care partners, and nephrologists recommended strategies to help prepare clinicians to have conversations with patients and families about future clinical trials for xenotransplantation such as going out into communities to listen to concerns and share information directly, and ensuring widespread, early education of kidney care teams as well as the medical community at large.

Breakthroughs in xenotransplantation offer great promise for addressing the critical organ donor shortage, particularly for those living with kidney failure. Our discussions with patients, care partners, and nephrologists underscore the need to prepare both clinicians and families for discussions about potential participation in a clinical trial for xenotransplantation. As with other kidney failure treatments, participants emphasized the utmost importance of equitable access to information and opportunity.