A recent Journal of Hepatology study reports the first successful pig-to-human auxiliary liver transplant. The patient survived for 171 days, demonstrating that modified pig livers can perform key metabolic and synthetic functions in humans. The case also highlights the ongoing technical and medical challenges that limit long-term survival in such procedures.
According to the World Health Organization, thousands die each year waiting for donor organs due to shortages. In China alone, hundreds of thousands of people develop liver failure each year, but surgeons performed only about 6,000 liver transplants in 2022. This experimental success points to a potential future solution for the critical gap between organ demand and availability.
Genetically Modified Pig Liver Transplanted into High-Risk Human Patient
The 71-year-old patient with hepatitis B–related cirrhosis and liver cancer was ineligible for surgery or a human liver transplant. Surgeons implanted an auxiliary liver from a genetically modified Diannan miniature pig, which had 10 specific gene edits. These modifications removed xenoantigens and added human genes to improve compatibility with the patient’s immune and coagulation systems.
During the first month, the pig liver functioned well, producing bile and coagulation factors, but surgeons removed it on day 38 due to xenotransplantation-associated thrombotic microangiopathy (xTMA). Treatment with the complement inhibitor eculizumab and plasma exchange successfully addressed the xTMA. The patient later suffered multiple episodes of upper gastrointestinal bleeding and passed away on day 171.
Pioneering Pig-to-Human Liver Transplant Shows Promise and Highlights Remaining Challenges
“This case shows a genetically engineered pig liver can function in a human long-term,” said Beicheng Sun, MD, PhD, noting ongoing coagulation and immune challenges.
Heiner Wedemeyer, MD, called the report a milestone, showing a genetically modified pig liver can function in a human while highlighting ongoing challenges. Xenotransplantation could offer new treatment options for patients with acute liver failure, acute-on-chronic liver failure, and liver cancer. A new era in transplant hepatology has begun.
The release of this case further cements the Journal of Hepatology as the premier liver journal worldwide. “We are committed to publishing cutting-edge hepatology research,” said Vlad Ratziu, MD, PhD, Editor-in-Chief of the Journal of Hepatology, Sorbonne Université, Paris.
Read the original article on: Sciencedaily
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