Genetically Engineered Pig Liver Sustains Human for 171 Days in Landmark xenotransplant
A groundbreaking study published in August 2025 in the Journal of Hepatology details the worldS frist successful auxiliary liver xenotransplant from a genetically modified pig to a living human, offering a beacon of hope for the thousands who die annually awaiting organ donation. The recipient survived for 171 days, demonstrating the potential of porcine livers to perform essential metabolic functions in humans, while also highlighting the significant challenges that remain before this technology can become widely available.
The global shortage of human organs for transplant is a critical health crisis. The World Health Organization estimates that thousands perish each year while on waiting lists. In China,the need is particularly acute,with hundreds of thousands diagnosed with liver failure annually,yet only approximately 6,000 receiving transplants in 2022. This pioneering case represents a potential pathway to address this life-or-death disparity.
The recipient, a 71-year-old man suffering from hepatitis B-related cirrhosis and hepatocellular carcinoma, was deemed ineligible for traditional liver resection or a human liver transplant. Surgeons then implanted an auxiliary graft – a partial liver – from a Diannan miniature pig that had undergone 10 precise gene edits. These modifications included removing genes that trigger immune rejection (xenoantigen knockouts) and adding human genes to improve compatibility with the recipient’s immune and coagulation systems.
For the first month following the surgery, the transplanted pig liver functioned effectively, successfully producing bile and synthesizing crucial coagulation factors, with no immediate signs of rejection. However, on day 38, complications arose. The graft was removed after the development of xenotransplantation-associated thrombotic microangiopathy (xTMA),a severe condition linked to complement activation and damage to the endothelial lining of blood vessels. Fortunately, treatment with the complement inhibitor eculizumab and plasma exchange successfully resolved the xTMA.
Despite this initial setback, the patient later experienced recurrent episodes of upper gastrointestinal hemorrhage and ultimately passed away on day 171. While the outcome was tragic, researchers emphasize the meaning of the 171-day period of graft function.
“This case proves that a genetically engineered pig liver can function in a human for an extended period,” stated beicheng Sun, MD, PhD, lead investigator from the Department of Hepatobiliary Surgery at anhui Medical university in China.”It is indeed a pivotal step forward, demonstrating both the promise and the remaining hurdles, particularly regarding coagulation dysregulation and immune complications, that must be overcome.”
Experts in the field are hailing the study as a watershed moment. “This report is a landmark in hepatology,” commented Heiner Wedemeyer, MD, Co-Editor of the Journal of Hepatology. “It shows that a genetically modified porcine liver can engraft and deliver key hepatic functions in a human recipient. At the same time, it highlights the biological and ethical challenges that remain before such approaches can be translated into wider clinical use. Xenotransplantation may open completely new paths for patients with acute liver failure, acute-on-chronic liver failure, and hepatocellular carcinoma. A new era of transplant hepatology has started.”
Vlad Ratziu, MD, PhD, editor in Chief of the Journal of Hepatology, added, “The publication of this case reaffirms the Journal of Hepatology as the world’s leading liver journal. We are committed to presenting cutting-edge translational discoveries that redefine what is absolutely possible in hepatology.”
The research, detailed in the article “Genetically engineered pig-to-human liver xenotransplantation” (Zhang, W., et al., 2025), marks a significant leap toward addressing the critical shortage of organs for transplant and offers a glimmer of hope for patients with life-threatening liver disease.
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