• Tatsuo Kawai, Winfred W Williams, Nahel Elias, Jay A Fishman, Kerry Crisalli, Alban Longchamp, Ivy A Rosales, Michael Duggan, Shoko Kimura, Leela Morena, Thiago J Borges, Toshihide Tomosugi, Ahmad Karadagi, Tsukasa Nakamura, Kassem Safa, Alessia Giarraputo, Claire T Avillach, Eva D Patalas, R Neal Smith, David H Sachs, A Benedict Cosimi, Joren C Madsen, CooperDavid K CDKCTransplant Center, Massachusetts General Hospital, Boston.Harvard Medical School, Boston., Richard Pierson, Steve Perrin, Ranjith P Anand, Sagar Chhangawala, Matthew Coscarella, Alexandre Daigneault, Feng Li, Owen Pearce, Wenning Qin, William T Serkin, Vincent Yeung, Kristen Getchell, Susan C Low, Michael Curtis, Robert B Colvin, and Leonardo V Riella.
• Transplant Center, Massachusetts General Hospital, Boston.
• N. Engl. J. Med. 2025 Feb 7.

AbstractXenotransplantation 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.).Copyright © 2025 Massachusetts Medical Society.

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