Richard Knight, MD, is the director of renal and pancreas transplantation at Houston Methodist J.C. Walter Jr. Transplant Center and the surgical director of kidney and pancreas transplantation in the Department of Surgery.

Richard Knight, MD

Crisis Point: Unmet Needs and New Horizons in Kidney Transplantation

Our mini-docuseries has returned, taking a comprehensive look at public health crises affecting the United States today, with global implications tomorrow. If the crisis point is the moment where a crisis will worsen or begin to get better, the question remains: where are we now?

From Unmet Needs to New Possibilities: The Evolving Future of Kidney Transplantation

For many patients, kidney transplantation offers a chance not just at prolonged survival, but at a life free from the burdens of dialysis. Despite decades of progress, the field continues to grapple with a constellation of unmet needs, including the shortage of available donor kidneys, geographic inequities in access, risks of rejection, and long-term graft attrition, all of which place lasting burdens on both patients and healthcare systems.

Recent years, however, have seen growing momentum and progress. Improvements in diagnostics are enabling more precise prediction of rejection risk and the tailoring of immunosuppression regimens. Evolving perfusion techniques like continuous hypothermic machine perfusion can better preserve organ quality and potentially extend the viable window between donation and transplantation. The safe use of HCV-positive donor kidneys and the emergent promise of xenotransplantation are also expanding the donor pool in ways once considered unlikely.

To fully realize the impact of these advancements, the system must evolve: policies must be modernized, regulatory pathways harmonized, infrastructure expanded, and equity prioritized so that advances reach the patients who need them most. Only through coordinated, system-level change can the promise of these breakthroughs translate into real-world benefit.

With sustained investment in innovation, equitable deployment of new technologies, and collaboration across stakeholders, the future of kidney transplantation looks bright.

Brief descriptions of the speakers featured in this project are provided below:

, chief medical officer of the American Kidney Fund

, director of renal and pancreas transplantation at Houston Methodist J.C. Walter Jr. Transplant Center and the surgical director of kidney and pancreas transplantation in the Department of Surgery

, surgical director of kidney and pancreas transplantation at Piedmont Healthcare

, a patient advocate and 3-time kidney transplant recipient, the most recent of which was with an HCV-positive donor kidney

 to see other episodes on improving health equity in eye care, disparities in cardiovascular health, insulin access in the United States, physician burnout across healthcare, and the ongoing obesity crisis.

Videos

A trio of experts and a patient advocate discuss unmet needs and recent innovations in kidney transplantation, from xenotransplantation to continuous hypothermic machine perfusion.

Richard Knight, MD

Articles