A living pig liver transplant: a medical milestone with a warning
In China, surgeons performed a living transplant of a pig liver into a 71-year-old man with liver cancer and late-stage liver disease. The pig liver came from a Diannan miniature pig that had been genetically modified ten times to reduce the risk of rejection. In the first month after the operation, the liver functioned and showed no clear signs of rejection, offering a hopeful signal in the race to solve organ shortages. Yet weeks later, a severe immune reaction began to damage the lining of blood vessels, foreshadowing the medical and ethical hurdles ahead in xenotransplantation.
In This Article:
Who was the patient and what happened in the operation
The patient, a 71-year-old man, had liver cancer and late‑stage liver disease and was not eligible for a conventional liver transplant or partial liver removal. The transplant allowed him to live with a pig liver temporarily; the early month was promising. On day 38, a serious immune‑mediated complication required removal of the pig liver. He was treated with medications and a procedure to remove harmful factors from the blood. The patient later suffered episodes of gastrointestinal bleeding and died on day 171.
What this proves — and what remains
Dr Beicheng Sun said the case proves that a genetically engineered pig liver can function in a human for an extended period. The liver in this case was modified ten times to prevent rejection and came from a genetically modified Diannan miniature pig. The study highlights both promise and hurdles, notably coagulation dysregulation and immune complications, that must be overcome. Xenotransplantation is an emerging field that experts hope could one day help people on organ waiting lists.
Context, data and expert verdicts
Dr Heiner Wedemeyer, a professor at Hannover Medical School and co-editor of the Journal of Hepatology, called the report a landmark in hepatology, noting that the pig liver could engraft and deliver key hepatic functions in a human recipient. He cautioned about the biological and ethical challenges that remain before wider clinical use. Dr Beatriz Domínguez-Gil, director of Spain’s National Transplant Organisation (ONT), said this is a new step in xenotransplant therapy but highlights obstacles such as the serious complication observed in this patient. Transplants in this area remain experimental, and further work is needed to perfect genetic modifications, improve immunosuppression, and identify early complications. Ideally, this should occur in properly designed clinical trials to evaluate short-, medium-, and long-term efficacy and safety. These cases offer a glimpse of a future in which xenotransplantation becomes a clinical reality as a bridge therapy or destination therapy. In the UK, 8,096 people—including 276 children—are on waiting lists for organ transplants. More than 600 people in the country are on the waiting list for a liver transplant, and the average wait is three to four months.
What comes next: the road ahead
The findings mark a new era in transplant hepatology, but the path forward will require careful science and policy: better genetic edits, improved immunosuppression, and early management of complications. Researchers and clinicians are calling for properly designed clinical trials to test safety and efficacy. If successful, xenotransplantation could become a bridge therapy for liver disease or, in the longer term, a destination therapy for patients on waiting lists.
