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Expression of human CD47 in pig glomeruli prevents proteinuria and prolongs graft survival following pig‐to‐baboon xenotransplantation

Nephrotic syndrome is a common complication of pig‐to‐baboon kidney xenotransplantation (KXTx) that adversely affects outcomes. We have reported that upregulation of CD80 and down‐regulation of SMPDL‐3b in glomeruli have an important role in the development of proteinuria following pig‐to‐baboon KXTx. Recently we found induced expression of human CD47 (hCD47) on endothelial cells and podocytes isolated from hCD47 transgenic (Tg) swine markedly reduced phagocytosis by baboon and human macrophages. These observations led us to hypothesize that transplanting hCD47 Tg porcine kidneys could overcome the incompatibility of the porcine CD47‐baboon SIRPα interspecies ligand‐receptor interaction and prevent the development of proteinuria following KXTx.