Technical Considerations in the Pig-To-Human Kidney Xenotransplant: A Historical Perspective

As the limited supply of human donor organs remains the greatest barrier to renal transplantation, porcine renal xenografts have the potential to reduce the organ shortage. Recent attempts at using genetically engineered porcine renal xenografts have met with technical and functional problems. It is theorized that if transplantation of the en bloc kidneys had been performed: (1) the double nephron mass would provide normal renal function, (2) the procedure would be easier and safer by using the larger and thicker donor aorta and vena cava instead of the smaller and thinner-wall renal vessels, and (3) the operative procedure would be less time consuming because there are only 2 anastomoses to perform instead of a minimum of 4. The literature review on the use of en bloc renal xenografts is performed, as well as the application on the long-term use of small pediatric kidneys in humans.