Xenotransplantation: Can pigs solve the organ shortage?

Xenotransplantation

FAQs

Can other organs besides hearts and kidneys be used?

Pig liver xenotransplants have succeeded in brain-dead humans, functioning without rejection for short periods using six-gene edited pigs, while pancreas trials remain preclinical or historical with challenges in endocrine function, though skin and blood cells show promise for quicker clinical use. Kidneys and hearts lead due to superior preclinical survival in non-human primates.

What are the estimated costs of xenotransplantation?

Projected costs for mature programs are estimated to range from $300,000 to $1,000,000 per organ. These figures are comparable to, or potentially lower than, the long-term expenses associated with allotransplantation, given the potential for scalable production. Initial costs include gene-edited pigs, manufacturing, surgical procedures, and lifelong monitoring; however, significant savings may be realized compared to ongoing dialysis or mechanical support.

Who qualifies as a patient for these trials?

Priority is given to end-stage patients with significant medical needs who lack viable alternatives like dialysis tolerance. Consideration is also based on a demonstrated capacity to benefit and eligibility for human allotransplantation to support informed decision-making. Recipients are required to adhere to lifelong monitoring and behavioral modifications. Trials target small, high-risk groups like those over 60 on waitlists.

Are animals other than pigs used for xenotransplantation?

Pigs dominate due to size compatibility, rapid breeding, and genetic editability, but nonhuman primates like baboons and chimpanzees were historically tested—now largely abandoned owing to endangered status, ethical issues, disease risks, and small litters. No other species like sheep or rabbits have reached comparable clinical stages.

Reference

1. Carrier, A. N., Verma, A., Mohiuddin, M., et al. (2022). Xenotransplantation: a new era. Frontiers in Immunology13, 900594.

2. Xi, J., Zheng, W., Chen, M., et al. (2023). Genetically engineered pigs for xenotransplantation: Hopes and challenges. Frontiers in Cell and Developmental Biology10, 1093534.

3. Pullen, L. C. (2024). Xenotransplantation moves toward clinical trials. American Journal of Transplantation24(4), 509-511.

4. Kwon, T., Song, B. S., & Lim, K. S. (2025). Pig-to-human lung xenotransplantation: advancing xenogeneic respiratory transplantation and clinical translation. Signal Transduction and Targeted Therapy10(1), 382.

5. Stelcer, E., Wozniak, A., Magner, D., et al. (2025). Genetically modified pigs with α1, 3-galactosyltransferase knockout and beyond: a comprehensive review of xenotransplantation strategies. Frontiers in Immunology16, 1663246.

6. Montgomery, R. A., Stern, J. M., Lonze, B. E., et al. (2022). Results of two cases of pig-to-human kidney xenotransplantation. New England Journal of Medicine386(20), 1889-1898.

7. Tanihara, F., Takemoto, T., Kitagawa, E., et al. (2016). Somatic cell reprogramming-free generation of genetically modified pigs. Science advances2(9), e1600803.

8. Denner, J. (2024). Porcine endogenous retroviruses in xenotransplantation. Nephrology Dialysis Transplantation39(8), 1221-1227.

9. Wang, Y., Chen, G., Pan, D., et al. (2024). Pig-to-human kidney xenotransplants using genetically modified minipigs. Cell Reports Medicine5(10).

10. Garry, D. J., Weiner, J. I., Greising, S. M., et al. (2022). Cardiac xenotransplantation: clinical impact of science and discovery. Circulation146(13), 961-963.

11. Cooper, D. K., & Cozzi, E. (2024). Clinical pig heart xenotransplantation—where do we go from here?. Transplant International37, 12592.

12. Hurst, D. J., Bobier, C., & Padilla, L. A. (2026). Ethical Issues Involved in Solid Organ Xenotransplantation. Clinical Anatomy39(1), 55-59.

13. Kögel, J. (2024). The public you want, the public you get: Exploring the relationship between the public and science in the debate on xenotransplantation. Public Understanding of Science33(8), 961-977.

14. Loupy, A., Preka, E., Chen, X., et al. (2025). Reshaping transplantation with AI, emerging technologies and xenotransplantation. Nature Medicine31(7), 2161-2173.

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