My understanding is that the firms who provide Medicare patient dialysis are very loathe to have patients exit their system, if they spend say $1000 on patient

My understanding is that the firms who provide Medicare patient dialysis are very loathe to have patients exit their system, if they spend say $1000 on patient care and bill Medicare, the US government, for $1200 that's $200 of very safe profit. If that patient gets a transplant that's $200 of lost profits, regardless of how much healthier the patient is, and so they have no incentive to help patients get a transplant. So for technologies, either xenotransplantation (GM pig kidneys) or artificial kidneys which eliminate dialysis, expect some push back from those firms, certainly expect them to have a more negative outlook on any safety studies etc. than you might expect if you think of them as neutral health professionals who are focused on patient outcomes. Which of course doesn't magically mean these alternatives end up safer and healthier, they might turn out cheaper but worse, whereupon pushing to keep dialysis makes sense and you'd find yourself on the same side as the profiteers, but this happens, just like if you thought Prohibition was wrong and you found yourself alongside people whose businesses prey on problem drinkers...