Introduction: Transplantation is the best treatment for kidney failure. Approximately 100,000 people are on the U.S. kidney allotransplant (alloTx) waitlist, yet only ~25,000 receive an alloTx annually. Dialysis is an alternative to alloTx yet carries a reduced quality of life (QoL). Kidney xenotransplantation (KXTx) is a promising alternative. The FDA has approved the initiation of first-in-human clinical trials in 2025.
Methods: A 32-item survey was completed by 522 kidney patients recruited via NKF’s patient database and social media channels. Respondents were largely female (56%) and aged 50-79, with a range of kidney function and treatment experiences.
The survey evaluates motivators for considering a KXTx, consideration of perceived risks, and perspectives on clinical trials. The survey provides a snapshot of patient attitudes of KXTx given recent developments; it does not encompass all possible risks or scenarios.
Results: 
Treatment Satisfaction: Comparison of Dialysis and AlloTx Recipients
Among those with a functioning alloTx, 81% reported being either very or completely satisfied with their alloTx. Meanwhile, 49% of dialysis patients reported only moderate satisfaction.

Sources of Information: Patients reported learning about KXTx primarily through news (68%) and social (30%) media. However, 49% prefer to receive KXTx information from medical professionals.

Support: Key motivators for considering a KXTx included avoiding time on dialysis (55%), improving QoL (46%), and reducing time on the alloTx waitlist (41%). Advancement of science was also cited (27%). Overall, patients were strongly (46%) or somewhat (33%) supportive of KXTx as a treatment option.

Risk Perceptions: Zoonotic infection was the most concerning risk; 36% reported they would not likely accept a KXTx due to this. Perceptions of other risks—such as catastrophic events, graft rejection, and potential ineligibility for future alloTx—were mixed, with responses split across levels of concern.

Clinical Trials: Patients expressed mild concern about potential clinical trial monitoring requirements. Weekly monitoring was the most acceptable (32%), followed by inpatient (23%) and daily (20%) monitoring. Urgency of need for alloTx was the leading factor influencing willingness to enroll (55%).

25% reported being somewhat likely and 24% moderately likely to accept a KXTx. Support for KXTx as a treatment option remained high (46% strongly; 32% somewhat supportive).

Conclusion: Patients view KXTx as a promising alternative to alloTx, with strong overall support despite concerns. Zoonotic infection was a key concern, while rejection and monitoring were less so. Negative feelings about dialysis may contribute to a patient’s decision to accept a KXTx. Urgency was the most significant factor in deciding on clinical trial participation. These findings offer valuable insights into patient priorities and may inform trial design, risk communication, and education strategies.