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Twelve baboons received xenografts with either calcineurin inhibitor (CNI)\u2010based or CD40\/154 costimulation blockade immunosuppression. Source\u2010specific screening prevented early xenograft antibody\u2010mediated rejection in recipients, and clinically relevant preservation with hypothermic machine perfusion\u2010maintained xenograft viability after off\u2010site procurement at a high health herd facility. No zoonotic infections were detected. Six of 12 recipients achieved survival &gt;3 months without evidence of cell\u2010 or antibody\u2010mediated rejection. CNI\u2010based regimens were well\u2010tolerated and achieved the longest survivals to date using this approach, contingent on maintenance of therapeutic drug levels. However, xenograft loss among recipients of each immunosuppression regimen was associated with complement activation and microangiopathy, despite 10 GE Xenokidney expression of h\n                    <jats:italic>CD46<\/jats:italic>\n                    and h\n                    <jats:italic>CD55<\/jats:italic>\n                    . Complement activation, potentially worsened by infection\u2010related inflammation, may lead to long\u2010term 10 GE Xenokidney failure.\n                  <\/jats:p>","DOI":"10.1111\/xen.70113","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T12:11:50Z","timestamp":1772971910000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Investigational New Drug Enabling Nonclinical Study of Xenogeneic Life\u2010Supporting Porcine Kidneys With 10 Gene Edits (10 GE) in a Nonhuman Primate Test System"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3868-0403","authenticated-orcid":false,"given":"Daniel L.","family":"Eisenson","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine  Baltimore Maryland 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