Pig Organs Could One Day Surpass Human Donors, Pioneering Surgeon Says
A groundbreaking clinical trial exploring xenotransplantation – the transplant of pig organs into living humans – is underway, with a leading surgeon suggesting these organs could ultimately prove superior to those from traditional human donors. Dr. Robert Montgomery, director of NYU Langone’s Transplant Institute, confirmed the first transplant of the trial has already been completed, with another anticipated in January.
The escalating global organ shortage is driving this ambitious research. According to the NHS Blood and Transplant, over 12,000 people in the UK alone have died or been removed from transplant waiting lists in the past decade without receiving a life-saving organ. This stark reality underscores the urgent need for innovative solutions.
The initial phase of the trial will involve six patients who are either ineligible for human kidney transplants or face a high likelihood of death or remaining untransplanted within five years. The pig organs utilized in the trial have undergone gene-editing in 10 key locations, a crucial step to minimize the risk of rejection by the human immune system. Should the US Food and Drug Administration (FDA) grant approval, the trial is poised to expand significantly, encompassing 44 additional transplants.
“The truth is that there’s just never going to be enough human organs,” Montgomery told the Guardian. This conviction stems not only from his professional experience but also from a deeply personal one. Montgomery, named one of Time Magazine’s most influential people of 2025, received a heart transplant himself in 2018 after suffering seven cardiac arrests and a month-long coma due to a hereditary heart condition, dilated cardiomyopathy, which also claimed the lives of his father and brother.
He understands the desperation of those awaiting a transplant. “Unless you’ve walked in the shoes of somebody who’s waiting for a transplant, you don’t really fully understand how unlikely it is that you’re going to receive a transplant in time,” he explained.
Montgomery’s dedication to expanding organ availability extends beyond xenotransplantation. He has championed innovative approaches like domino-paired kidney transplants, a system that strategically matches living donors with incompatible recipients to create a chain of transplants. He has also pioneered the use of organs from donors with hepatitis C, successfully treating recipients with medication to eliminate the infection, and even received a hepatitis C-positive heart for his own transplant.
However, Montgomery acknowledges that incremental improvements to the existing system are insufficient. “Having spent a career trying to increase incrementally the number of human organs available, I realised that we just weren’t making that much progress, not in a meaningful way,” he said. “And any progress we made was kind of deleted by the ever-expanding number of people who are waiting for transplants.”
While the concept of xenotransplantation isn’t new, recent advancements, particularly in gene-editing technology, have brought it to the forefront. “There were all these kind of jokes about xenotransplantation, like it’s just around the corner and it’s an awfully long corner,” Montgomery remarked. “But suddenly we’re in it.” He led the world’s first successful gene-edited pig-to-human organ transplant in 2021, using a brain-dead recipient to gather critical safety data and demonstrate the initial viability of the procedure.
Montgomery envisions a future where pig organs not only address the organ shortage but potentially surpass human organs in terms of suitability. “They could be superior at some point because we can constantly modify them to make them better, where you can’t do that with a human organ,” he stated. Research indicates that transplanting the pig’s thymus alongside the kidney could further enhance tolerance and potentially reduce or eliminate the need for anti-rejection drugs. “We’re not there yet, but that’s why we’re doing those studies,” he added.
Previous attempts at pig organ transplants into humans, primarily involving severely ill patients, have yielded mixed results, with some recipients requiring organ removal and others succumbing to complications – though not necessarily directly related to the transplant itself. However, Montgomery noted that two individuals are currently living with functioning pig kidneys.
He identified kidneys and hearts as the most promising organs for xenotransplantation, while acknowledging that lung transplants present greater challenges. The viability of pig liver transplants remains uncertain. A chart illustrating the success rates of different xenotransplantation organ types would be beneficial here.
Remarkably, Montgomery would even consider receiving a pig heart himself if the need arose. “Next time around, if I continue to be healthy and alive, I certainly would consider it,” he said, driven by a desire to provide his children, who share his genetic predisposition to dilated cardiomyopathy, with more options than he and his family previously had.
