China achieves world’s first gene edited pig liver xenotransplantation

Surgeons transplant a pig liver into a 71-year-old male patient on May 17, 2024. /First Affiliated Hospital of Anhui Medical University

Surgeons transplant a pig liver into a 71-year-old male patient on May 17, 2024. /First Affiliated Hospital of Anhui Medical University

On May 17, China successfully conducted the world’s first liver cross-species transplants in a cancer patient using a 10-gene edited pig organ at a hospital in east China’s Anhui Province.

According to the hospital, the patient is able to walk freely seven days after the surgery and no signs of rejection have been observed. The transplanted liver functions normally, with a daily bile secretion of approximately 200 milliliters, indicating the organ’s successful integration and functionality.

“This marks a genuine xenogeneic pig liver transplant into a living person, paving the way for full liver transplants in the future,” said Sun Peicheng, the chief surgeon and the president of the First Affiliated Hospital of Anhui Medical University.

He told CGTN in a phone interview that the success of the transplant will give hope to patients with liver cancer in the future.

Pig organ transplants

Xenotransplantation, the practice of transplanting organs from one species to another, especially from pigs to humans, has been a long-held aspiration among surgeons due to an ongoing dearth of available human organs, according to an article published in Nature recently.

Scientists are pinning their hopes on pigs as potential organ donors, given the compatibility in size and anatomy between pigs’ organs and those of humans. However, the human body’s natural tendency to reject xenotransplanted organs, coupled with the risk of infection from undetected viruses within the organ, presents significant challenges for these transplants.

The world’s first xenotransplants into humans were all conducted in the United States. The first one was a 57-year-old patient receiving a pig heart, who survived for 60 days after the procedure. The second man received a pig heart in 2023 and survived for 40 days.

The first living recipient of a pig kidney died on May 7, two months after the transplant. But the doctors claimed his death was unrelated to the transplant, as the patient’s kidney was functioning well the day before his death, according to Nature.

The fourth xenotransplant in a live person was conducted on a 54-year-old woman from New Jersey, using a pig with only a single genetic modification.

Xenotransplant in China and ethical use

Existing cases had offered hope to desperately ill people who had run out of options, but no transplants had been conducted in China. The only experimental procedures were conducted in two brain-dead human recipients in March.

The procedure conducted at the First Affiliated Hospital of Anhui Medical University was the first of its kind worldwide, “providing great significance for the study of human tolerance,” Sun said.

The surgery was performed on a 71-year-old male suffering from a large hepatic tumor in the right lobe of his liver. He was faced with a critical health situation with limited treatment options.

The hospital assembled a multidisciplinary team consisting of academic experts, clinical ethics specialists, organ transplant ethicists and animal ethicists. Guided by the principles of compassion, urgency and non-harm, and after obtaining fully informed consent from the patient and his family, the committee agreed to proceed with xenogeneic auxiliary liver transplantation research for the patient.

During the surgery, the patient’s massive right liver tumor was removed, and it was confirmed during surgery that the remaining left lobe was insufficient to meet the liver function needs of the patient.

For the procedure, the team used a 514-gram liver from a 10-gene edited male pig, aged 11 months and weighing 32 kilograms. It was cultivated by a research team from Yunnan Agricultural University.

Sun told CGTN that he adopted an innovative way of transplanting the lobe into the patient’s right hepatic cavity by turning the right liver by 45 degrees.

“The surgery has set surgical procedure standards on transplanting pig livers into the human body, providing comprehensive solutions on when to use immune-suppressing drugs, and on how to care for patients before, during, and after xenogeneic liver surgery,” said Sun.