Doctors analyze the case of a patient who survived 171 days on a genetically modified pig's liver: 'A crucial breakthrough'

A medical team from Anhui Medical University in China managed to help a 71-year-old patient survive 171 days (almost 6 months) after receiving an auxiliary liver graft from a genetically modified Diannan miniature pig.

The case, published by Elsevier in the Journal of Hepatology , represents the world's first successful auxiliary liver xenotransplant and opens a potential avenue for addressing the global shortage of human organs.

The recipient suffered from cirrhosis associated with hepatitis B and hepatocellular carcinoma, and was not a candidate for human transplantation or surgical resection.

Surgeons implanted a graft from a pig with 10 genetic modifications intended to improve immune compatibility and reduce the risk of rejection.

These included the elimination of xenoantigens and the introduction of human genes related to coagulation and immune response.

During the first month after the operation, the porcine liver functioned efficiently: it produced bile, synthesized coagulation factors, and showed no signs of acute or hyperacute rejection.

On day 38, physicians detected xenotransplant-associated thrombotic microangiopathy (xMAT), a serious complication linked to complement activation and endothelial damage.

The team treated the condition with eculizumab—a complement inhibitor—and plasmapheresis, temporarily stabilizing the patient.

Despite the initial favorable response, the patient subsequently experienced several episodes of upper gastrointestinal bleeding and died on day 171 after surgery.

According to the World Health Organization, thousands of people die each year waiting for a transplant due to a lack of donors. In China, only about 6,000 people received a liver transplant in 2022, while hundreds of thousands suffer from liver failure each year.

“This case demonstrates that a genetically modified pig liver can function in humans for a long time,” explained lead researcher Beicheng Sun, of the Department of Hepatobiliary Surgery at the First Affiliated Hospital of Anhui Medical University.

Professor Sun called the procedure “a crucial advance that demonstrates both the potential and the remaining obstacles, particularly those related to coagulation dysregulation and immune complications, that must be overcome.”

Experts agree that liver xenotransplantation could become a key tool in bridging the gap between organ demand and availability, although they caution that years of research are still needed before its routine clinical application.

*This content was rewritten with the assistance of artificial intelligence, based on information from Europa Press, and reviewed by the journalist and an editor.