Purpose of Review
Xenotransplantation has emerged as a promising frontier in the field of kidney transplant surgery as a result of recent successful pig-to-human experiments (Fischer and Schnieke in Transgenic Res. 31(3):391-398, 2022; Montgomery et al. in Xenotransplantation. 28(6), 2021; Cooper in Xenotransplantation. 28(6), 2021; Porrett et al. in Am J Transplant. 22(4):1037 1053, 2021). The potential of gene-knockout porcine models to address the kidney shortage offers hope for a future where xenograft procedures become mainstream. Successful implementation of xenotransplantation as a supplement to, and eventual replacement for, allotransplantation raises key questions about potential ethical, logistic, and disparity-related challenges that may arise with a near-unlimited organ supply (Cowan et al.in Kidney Int. 85(2): 265-275, 2014; Carrier et al. in Front Immunol. 13, 2022). This review aims to anticipate how porcine xenotransplantation, once implemented to the extent that the current kidney shortage is eliminated, will shift the transplantation landscape at both patient-provider and health systems levels (Fischer and Schnieke in Transgenic Res. 31(3):391-398, 2022; Montgomery et al. in Xenotransplantation. 28(6), 2021; Cooper in Xenotransplantation. 28(6), 2021; Porrett et al. in Am J Transplant. 22(4):1037 1053, 2021).
Summary
Despite the sparse existing literature, we hope the forward-thinking approach of this review will help facilitate the equitable dissemination of porcine grafts once they become viable alternatives to human kidneys for patients with End Stage Renal Disease (ESRD).
