Pig liver to human transplant: in China: a short story that may get longer...

 Here's a forthcoming article in the Journal of Hepatology.

Pioneering transplantation often provides tragic short stories of first attempts, that over time become longer, much more hopeful stories. 

Genetically engineered pig-to-human liver xenotransplantation

Zhang, Wenjie et al., Journal of Hepatology,

"In China alone, hundreds of thousands of individuals experience liver failure every year, but only approximately 6000 received a liver transplant in 2022[6]. Compared to the heart and kidney, the human liver exhibits more complex functions, including metabolism, detoxification, and immune regulation, which present unique challenges in xenotransplantation and might limit the success of cross-species transplantation[7, 8]. Encouragingly, xenotransplantation of pig livers has experienced a surge in 2024. In January, a United States based team connected a genetically modified pig liver outside the body of a brain-dead person, and the liver circulated the patient’s blood for three days[9]. In March, a Chinese team transplanted a 6-gene edited pig liver into a brain-dead individual and lasted for 10 days[10]. The pig liver exhibited signs of functionality, including the daily secretion of more than 30 milliliters of bile, which aids in digestion and is indicative of its metabolic activity[11]. These studies provide evidence of the feasibility and functionality of genetically modified porcine-to-human liver xenotransplantation. ... Unlike full xenotransplantation, which requires complete removal of the native liver, auxiliary xenotransplantation preserves a portion of the recipient’s liver while providing additional hepatic support. This less invasive strategy offers potential as a bridging therapy for patients awaiting recovery or subsequent human liver transplantation. In this groundbreaking study, a 71-year-old patient was the first living individual to receive a liver transplant from a genetically modified pig. During the initial 31 postoperative days, the patient showed no signs of infection or rejection, with gradual improvements in liver function and coagulation parameters. 

"However, on day 31, symptoms of xenotransplantation-associated thrombotic microangiopathy (xTMA) emerged, and antibody therapy was ineffective. As a result, the porcine liver was removed, relying on regeneration of the patient's left hepatic lobe. Following a course of antibody treatment, the xTMA symptoms resolved. Unfortunately, on postoperative day 135, the patient experienced sudden upper gastrointestinal hemorrhage. Despite repeated medical interventions, the bleeding episodes persisted. ultimately leading to the patient’s death on postoperative day 171."