World's First Successful Liver Xenotransplantation Achieved in China

In October 2025, a multidisciplinary team at the First Affiliated Hospital of Anhui Medical University in Hefei, China, achieved a groundbreaking medical milestone by performing the world's first auxiliary liver xenotransplantation from a genetically modified pig into a living human patient. The recipient, a 71-year-old man suffering from end-stage liver disease due to hepatitis B and liver cancer, was ineligible for a human liver transplant. Surgeons implanted a liver from a specially engineered Diannan miniature pig, which had undergone ten genetic modifications to enhance compatibility with the human immune system and improve blood clotting functions. The pig liver functioned effectively for 38 days, supporting the patient's metabolic processes without signs of acute rejection. However, on day 38, the patient developed xenotransplantation-associated thrombotic microangiopathy (xTMA), a serious condition linked to immune reactions and blood vessel damage. Despite treatments, the patient experienced repeated internal bleeding and died on postoperative day 171. This case was detailed in the Journal of Hepatology on October 9, 2025.

Xenotransplantation, the transplantation of organs or tissues between different species, has long been explored as a potential solution to the critical shortage of human donor organs. According to the World Health Organization, thousands of patients die each year while waiting for organ transplants due to the limited supply of human organs. In China alone, hundreds of thousands experience liver failure annually, yet only around 6,000 people received a liver transplant in 2022. Advancements in genetic engineering have made it possible to modify pig organs to reduce the risk of rejection and improve compatibility with human recipients. Previous xenotransplantation efforts have included pig heart and kidney transplants into humans, with varying degrees of success. For instance, in March 2025, Chinese researchers reported the successful transplantation of a gene-edited pig kidney into a living patient, marking only the third such case globally.

The surgical team, led by Dr. Beicheng Sun, President of the First Affiliated Hospital of Anhui Medical University, selected a Diannan miniature pig as the organ donor. This pig underwent extensive genetic modifications: three genes responsible for rapid antibody-mediated rejection were knocked out, and seven human genes were inserted to improve immune acceptance and prevent blood clotting complications. The auxiliary liver was implanted alongside the patient's native liver, allowing the pig liver to support essential metabolic functions. For the first 38 days post-transplant, the pig liver produced bile and synthesized coagulation factors without signs of acute rejection. However, on day 38, the patient developed xTMA, a condition characterized by blood vessel damage and clotting issues. Despite medical interventions, the patient experienced repeated internal bleeding and succumbed on postoperative day 171.

This case demonstrates that genetically engineered pig livers can perform essential functions in human bodies, marking a significant advancement in xenotransplantation. However, it also highlights the challenges that remain, particularly regarding immune complications and coagulation issues. Dr. Sun emphasized the importance of this development, stating, "This case proves that a genetically engineered pig liver can function in a human for an extended period. It is a pivotal step forward, demonstrating both the promise and the remaining hurdles, particularly regarding coagulation dysregulation and immune complications, that must be overcome."

Prior to this achievement, xenotransplantation efforts primarily involved brain-dead patients. For example, in March 2025, Chinese researchers transplanted a gene-edited pig liver into a brain-dead patient, with the organ functioning for 10 days. The October 2025 case is notable as it involved a living recipient and demonstrated a longer duration of organ function.

The success of this procedure has significant societal implications, offering hope to patients with end-stage liver disease who are ineligible for human transplants. However, it also raises ethical questions regarding the use of genetically modified animals for organ donation and the long-term viability and safety of such procedures. The development of xenotransplantation therapies must balance scientific progress with ethical considerations and public acceptance.

The world's first successful auxiliary liver xenotransplantation from a genetically modified pig into a living human represents a monumental step in medical science. While the procedure demonstrated the potential for pig livers to support human life, it also underscored the complexities and challenges that remain. Ongoing research and ethical discourse will be essential as the field of xenotransplantation continues to evolve.