Progress in life-supporting kidney transplantation in the genetically-engineered pig-to-nonhuman primate model has been encouraging, with pig kidneys sometimes supporting life for > 1 year. What steps need to be taken by (i) the laboratory team, and (ii) the clinical team to prepare for the first clinical trial? The major topics include (i) what currently-available genetic modifications are optimal to reduce the possibility of graft rejection, (ii) what immunosuppressive therapeutic regimen is optimal, and (iii) what steps need to be taken to minimize the risk of transfer of an infectious microorganism with the graft. We suggest that patients who are unlikely to live long enough to receive a kidney from a deceased human donor would benefit from the opportunity of a period of dialysis-free support by a pig kidney, and the experience gained would enable xenotransplantation to progress much more rapidly than if we remain in the laboratory.

在基因工程猪到非人灵长类动物模型中支持生命的肾移植方面取得了令人鼓舞的进展，猪肾有时可以支持生命超过一年。 (i) 实验室团队和 (ii) 临床团队需要采取哪些步骤来准备首次临床试验？主要主题包括（i）目前可用的基因修饰对于降低移植物排斥的可能性是最佳的，（ii）什么免疫抑制治疗方案是最佳的，以及（iii）需要采取哪些步骤来最大程度地减少移植物转移的风险移植物中存在感染性微生物。我们建议，不太可能活到足够长的时间接受已故人类捐赠者肾脏的患者将受益于猪肾一段时间的免透析支持机会，并且所获得的经验将使异种移植进展得更快比我们留在实验室更有效。