Surgeons in China have made a remarkable advancement in medical science by successfully transplanting a section of liver from a genetically modified pig into a human patient battling cancer. This groundbreaking procedure was disclosed in a report published on Thursday in The Journal of Hepatology.
The surgical team performed a complex operation on a 71-year-old patient, who had a tumor the size of a grapefruit in the right lobe of his liver. After removing the diseased lobe, they grafted the porcine liver segment onto the patient’s remaining left lobe. Post-surgery, the pig liver began functioning effectively, producing bile and synthesizing crucial blood clotting factors. Notably, the patient’s body did not reject this foreign organ, allowing the left lobe of his liver to regenerate.
However, 38 days following the transplant, complications arose, necessitating the removal of the pig liver. Unfortunately, the patient, who was already in advanced disease stages, passed away just over five months later. The authors of the report noted that because of his advanced cancer and hepatitis B-related cirrhosis, he would have been ineligible for a human organ donor in China.
Dr. Heiner Wedemeyer, a co-editor of the journal, praised the surgery as a “breakthrough” and a “historical clinical milestone,” though he highlighted that further research is essential to prevent complications and excessive blood clotting in future cases. “A new era of transplant hepatology has started,” he declared.
Dr. Heidi Yeh, an associate professor at Harvard Medical School and a transplant surgeon, commended the researchers for their courage, especially given the previous unsuccessful attempts at transplanting genetically modified pig livers into nonhuman primates, which had dissuaded many scientists from pursuing this avenue. “I think this is a landmark development,” she said. “They put a pig’s liver in a human for a month, and the human did fine.”
This achievement underscores the urgency and rapid pace at which Chinese medical researchers are advancing the use of genetically modified pig organs to address the pressing healthcare needs of the nation’s large population. There is particular enthusiasm for using gene-edited pig kidneys to assist the more than 1.2 million individuals in China suffering from kidney failure. Recently, surgeons reported a significant milestone: a 69-year-old woman lived with a functioning kidney from a genetically modified pig for over six months, a notable achievement compared to an American patient who also continues to live healthily after receiving a pig kidney in January.
Furthermore, Chinese surgeons recently made headlines by transplanting a pig’s lung into a brain-dead patient, a procedure deemed immensely challenging and rarely undertaken elsewhere.
Liver disease presents an acute public health crisis in China, with over 300,000 people experiencing liver failure annually and an alarming shortage of human donor organs. In 2022, only around 6,000 individuals in China received liver transplants from human donors.
Dr. Beicheng Sun, a surgeon at Anhui Medical University and the lead author of the paper, stated that the original plan was for the pig liver transplant to be temporary. “I never wanted that pig liver in the body for too long — I think that’s impossible,” he explained. He envisioned the pig liver functioning as a bridge until the patient’s liver could regenerate or a human donor organ became available.
“This shows good potential to get the liver to regenerate,” Dr. Sun commented. He noted the importance of having a special support mechanism until the liver function regained strength. He emphasized that if a xenotransplanted liver from a nonhuman source could temporarily function, there might be enough crucial time—one to three months—to secure a donor organ.
While American surgeons have begun to transplant hearts and kidneys from genetically modified pigs into a limited number of patients, they have hesitated to undertake liver xenotransplantation due to the complexities involved. Past experimental research indicated that most transplanted livers from genetically modified pigs into nonhuman primates failed within a month, prompting a shift towards a dialysis-like approach. This method involves circulating the blood of liver patients through a genetically engineered pig liver outside the body.
The Food and Drug Administration (FDA) has approved a clinical trial for this treatment targeting critically ill patients with chronic liver failure facing acute, life-threatening episodes. This procedure is designed to serve as a temporary bridge for liver patients desperately in need of a transplant, rather than a long-term solution.
