Over the past year, several new research insights and policy changes have advanced the field of kidney transplantation: kidney xenotransplantation has reached its first human recipients, previously under-used organs are becoming transplantable with new procurement and preservation approaches, and post-transplant care, including prevention of complications, has become safer.
Key advances
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After the creation of a triple-knockout pig facilitated the early development of xenotransplantation, new xenoantigens have been defined, along with corresponding antibody detection assays.
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Engineered expression of human transgenes dampens antibody responses and prolongs graft survival in xenotransplantation of porcine kidneys into nonhuman primates.
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Development of a nutrient-supplemented perfusate can maintain metabolic activity of kidneys undergoing sub-normothermic perfusion without signs of cellular damage for up to 4 days.
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The international Santander Summit released recommendations, now adopted by the World Health Assembly, that donation after circulatory death and normothermic regional perfusion should be supported by global transplant organizations to expand kidney transplantation worldwide.
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A new alternative to valganciclovir provides a safer way to prevent cytomegalovirus infection after transplantation.
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References
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Acknowledgements
K.L.L. is supported by the Mid-America Transplant/Jane A. Beckman Endowed Chair in Transplantation, receives funding related to kidney transplantation from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK: R01DK139339, R01DK120551), and is a senior scientist of the Scientific Registry of Transplant Recipients (SRTR).
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K.L.L. receives consulting fees from CareDx and speaker honoraria from Sanofi. V.A.F. declares no competing interests.
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Fleetwood, V.A., Lentine, K.L. Multifaceted innovations needed to advance transplant nephrology. Nat Rev Nephrol (2025). https://doi.org/10.1038/s41581-024-00924-z
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DOI: https://doi.org/10.1038/s41581-024-00924-z
