Breakthrough Pig Liver Transplant Using Gene Editing Signals New Era in Organ Donation
A milestone achievement in medical science has been reached as doctors at the Xijing Hospital of Air Force Military Medical University successfully completed two groundbreaking transplants involving gene-edited pig livers being transplanted into brain-dead human recipients. The remarkable procedure, detailed in a recent report, showcases the potential of utilizing genetically modified animal organs in human transplantation.
The pioneering work conducted in China represents a significant leap forward in addressing the persistent shortage of viable human organs for transplant, with over 100,000 individuals currently on waiting lists in the United States alone. The use of pig organs as a potential alternative has long been explored due to their anatomical similarities to human organs.
In a separate study, Penn Medicine achieved a breakthrough last year by carrying out the first successful external liver perfusion using a gene-edited pig liver, which demonstrated promising results. While previous attempts at transplanting gene-edited pig kidneys and hearts have shown some success, liver transplants have presented unique challenges due to the organ’s multifaceted functions.
The liver’s essential roles in filtering blood, metabolizing nutrients, detoxifying harmful substances, producing bile, aiding digestion, clotting blood, and regulating blood sugar make it a complex organ to replicate. Dr. Lin Wang, a key figure involved in the research, emphasized the intricate nature of working with the liver and described the organ’s functions as highly intricate and essential.
Despite the progress made in xenotransplantation – the transfer of animal organs to humans – experts acknowledge that liver transplants pose distinct hurdles. The liver’s dual blood supply and intricate functions necessitate a more nuanced approach compared to other organs like the heart or kidneys. Dr. Shimul Shah, a leading authority in this field, highlights the ongoing challenges in adapting pig organs for human use, noting that further advancements are required before liver transplants become routine.
With thousands awaiting liver transplants in the US alone, the successful integration of pig livers could offer a vital lifeline to patients with acute liver failure. The potential for pig liver transplants to serve as a temporary solution while awaiting a human donor organ could significantly impact patient outcomes and alleviate the strain on existing transplant systems.
Dr. Shah emphasized the importance of providing a functioning organ to transplant patients, suggesting that a pig organ could be a suitable option. The groundbreaking transplant procedure took place in March 2024 in China, where scientists made genetic modifications to a Bama miniature pig liver to enhance compatibility with the human body. Despite implanting the pig organ in the patient, the human liver was left in place as a precaution. There were doubts about whether a pig liver could fully substitute for a human liver due to potential differences in volume and production capacity.
In addition to this recent study, the Chinese team revealed that they had also performed a pig-to-human liver transplant involving the removal of the human liver, although specific details have not been disclosed. Following the transplant, the experiment was concluded at the family’s request after ten days. Dr. Wang noted that their work on xenotransplantation was influenced by successful kidney and heart transplants in the US, as well as their own prior animal studies.
Previously, Dr. Wang and his team had achieved a milestone in 2013 by transplanting a pig liver into a monkey, which survived for 14 days. They had also conducted pig-to-monkey transplants involving the heart, kidney, cornea, skin, and bone. A recent pig kidney transplant into a human patient is expected to result in a successful recovery, although details are pending publication.
Dr. Shah, part of the Mass General Brigham team that conducted a successful pig kidney transplant to a human, remains cautiously optimistic about liver xenotransplantation, noting the need for further research progress. Dr. Vagefi from UT Southwestern Medical Center emphasized the incremental advancements in transplantation science, acknowledging the potential of such research to benefit patients in need.
