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Updated: Jan 15, 2026
Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
Genetically engineered pig-to-human liver xenotransplantation
Wenjie Zhang1, Qingxiang Xu1, Kaixiang Xu2
1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; MOE Innovation Center for Basic Research in Tumor Immunotherapy, Hefei, Anhui, China; Anhui Province Key Laboratory of Tumor Immune Microenvironment and Immunotherapy, Hefei, Anhui, China.
This study details the first auxiliary pig-to-human liver xenotransplantation in a living recipient, achieving 171 days of survival. It highlights xenotransplantation-associated thrombotic microangiopathy as a key challenge for future research.
Area of Science:
- Transplantation Biology
- Xenotransplantation
- Genetically Engineered Organs
Background:
- Pig-to-human liver xenotransplantation remains an unexplored area, unlike cardiac and renal applications.
- This research addresses the critical need for alternative organ sources due to donor shortages.
Purpose of the Study:
- To report the world's first successful auxiliary pig-to-human liver xenotransplantation in a living recipient.
- To analyze the factors influencing the success and challenges of this pioneering procedure.
Main Methods:
- A 10-gene-edited pig liver was transplanted as an auxiliary organ into a patient with unresectable liver cancer.
- Comprehensive monitoring of liver function, metabolic status, and coagulation markers was performed.
Main Results:
- The patient achieved 171 days of survival with stable hepatic and renal function for the initial 31 days.
- Xenotransplantation-associated thrombotic microangiopathy (xTMA) emerged as a complication, successfully managed with eculizumab and plasma exchange.
- The porcine graft demonstrated metabolic activity, bile secretion, and coagulation correction.
Conclusions:
- Auxiliary porcine liver xenotransplantation is feasible as a bridge to human liver transplantation.
- Managing postoperative xTMA is crucial for improving long-term xenotransplantation outcomes.
- Further research is essential to overcome challenges and advance clinical xenotransplantation.
