Pig Liver Transplant Patient Lives 171 Days in Medical First

Groundbreaking Xenotransplantation Achievement

In a landmark medical breakthrough that could revolutionize organ transplantation, Chinese doctors have successfully performed the world's first pig-to-human liver transplant in a living patient. The 71-year-old man with hepatitis B-related cirrhosis and liver cancer survived for 171 days after receiving a genetically modified pig liver, with the animal organ functioning effectively for 38 days before being removed due to complications.

'Everyone always says, "oh, liver is too complicated to transplant, compared to the heart or kidney," but after this, in the future, I think people will think differently,' said Dr. Beicheng Sun, president of the First Affiliated Hospital of Anhui Medical University and co-author of the study published in the Journal of Hepatology.

Technical Details and Procedure

The patient received a liver from an 11-month-old Diannan miniature pig that had been cloned with 10 specific gene edits designed to reduce the risk of infection and organ rejection. The pig's genetic modifications targeted immune system compatibility and coagulation factors, making the organ more suitable for human transplantation. Doctors also administered immunosuppressive drugs to prevent the patient's body from rejecting the foreign organ.

The surgical team performed an auxiliary liver transplantation, meaning they attached the pig liver to what remained of the patient's own liver rather than completely replacing it. This approach allowed the patient's remaining liver tissue to potentially regenerate while the pig organ provided temporary support.

Initial Success and Complications

Immediately after the transplant, the pig liver began functioning normally, turning red and producing bile within hours. 'Right away, the pig liver turned red, and bile started draining from the external bile duct, with secretion progressively increasing over time,' the researchers reported. Liver function indicators showed significant improvement within the first day, and there were no initial signs of inflammation or rejection.

However, complications emerged around day 25 when the patient's heart began showing progressive stress. By day 37, his blood pressure plummeted and he experienced periods of unconsciousness. The medical team diagnosed xenotransplantation-associated thrombotic microangiopathy (xTMA), a condition where microscopic blood clots damage small blood vessels and organs.

Significance for Organ Shortage Crisis

This breakthrough comes at a critical time when organ shortages remain a major global health challenge. According to US Health Resources & Services Administration data, more than 100,000 people are on organ transplant waiting lists in the United States alone, with over 9,000 specifically needing liver transplants. Livers represent the second greatest need after kidneys.

'In the future, maybe the left side can get a real chance to regenerate, and in that case, we would remove the graft, and that would be enough to support the life, or at least we know we can wait one or two months for a graft from a human that could save his life,' Dr. Sun explained, highlighting the potential for pig livers to serve as bridging therapy.

Expert Reactions and Future Implications

Dr. Heiner Wedemeyer, a professor at Hannover Medical School in Germany who co-authored an editorial accompanying the study, called the achievement 'really groundbreaking.' He added, 'For me as a transplant hepatologist, it really opens completely new views and ideas.'

Wedemeyer noted that he recently saw a patient with acute liver failure who didn't qualify for human organ transplantation due to cancer issues. 'If I would have had, at this stage, use of a pig liver to bridge her – because she may need three, four, five, six, seven weeks to recover with her own liver – I would have done this,' he told CNN.

The field of xenotransplantation has seen significant advances in recent years, with successful pig kidney and heart transplants in humans, but the liver has been considered particularly challenging due to its complex functions and dual blood supply.

Patient's Journey and Legacy

The patient initially suffered from hepatitis B-related cirrhosis and had a large tumor in the right lobe of his liver. When conventional treatments failed and family members weren't suitable donors, the experimental pig liver transplant became his only remaining option.

'We need to have great respect for this patient and their family,' Dr. Sun emphasized. 'The patient provides such a special contribution to the field of this science, and we need to be grateful for all of these patients who have made such a big contribution to this field.'

After the pig liver was removed on day 38, the patient's own liver continued to function well. However, he developed upper gastrointestinal bleeding on day 135 and ultimately passed away 171 days after the initial transplant procedure.

While the patient's death underscores the challenges that remain, researchers say the case provides invaluable insights that will help advance the field. The study demonstrates that genetically modified pig livers can provide effective hepatic support while preserving part of the native liver, confirming their clinical feasibility as a bridging strategy for patients awaiting human donor organs or liver regeneration.