Patient Survives 171 Days After World’s First Genetically Modified Pig Liver Transplant

MADRID (EUROPA PRESS) – A groundbreaking study led by Anhui Medical University in China and published in the ‘Journal of Hepatology’ by Elsevier, reports on the world’s first auxiliary liver xenotransplant from a genetically modified pig to a living human recipient. The patient survived for 171 days, showcasing that genetically altered pig livers can support critical metabolic and synthetic functions in humans, while also highlighting the complications that currently restrict long-term outcomes.

According to the World Health Organization, thousands die each year awaiting organ transplants due to a lack of available human organs. Specifically in China, hundreds of thousands suffer from liver failure annually; however, only about 6,000 individuals received liver transplants in 2022. This pioneering case presents a new potential solution to narrow the gap between organ demand and supply.

The subject was a 71-year-old man with hepatitis B-related cirrhosis and hepatocellular carcinoma, who was ineligible for resection or human liver transplant. Surgeons implanted an auxiliary graft from a genetically modified Diannan miniature pig with 10 genetic modifications, including knockout genes for xenoantigens and human transgenes to enhance immune and coagulation compatibility.

In the month following the operation, the graft effectively produced bile and synthesized coagulation factors, with no signs of acute or hyperacute rejection. Nonetheless, on day 38, the graft was removed following the onset of xenotransplant-associated thrombotic microangiopathy (xMAT), a severe complication linked to complement activation and endothelial injury. Treatment with the complement inhibitor eculizumab and plasmapheresis successfully resolved the xMAT. Despite this, the patient later experienced multiple episodes of upper gastrointestinal bleeding and died on day 171.

“This case proves that a genetically modified pig liver can function in a human for an extended period,” states lead researcher Beicheng Sun, from the Department of Hepatobiliary Surgery and president of the First Affiliated Hospital of Anhui Medical University. “It is a significant breakthrough that shows both the potential and the challenges yet to be overcome, particularly those related to coagulation deregulation and immune complications,” he concludes.