Surgeons in China have achieved a groundbreaking milestone in medical science by performing the world's first combined transplant of a whole pig liver and both kidneys into a brain-dead human recipient. The procedure, led by a team at the Second Affiliated Hospital of Guangxi Medical University in southern China, resulted in nearly five days of organ function without hyperacute rejection, according to the university's announcement on Monday.
Gene-Edited Pig Donor
The donor was a six-gene-edited pig with body size and physiological characteristics highly similar to those of humans. Xenotransplantation, or the transfer of animal organs into humans, has emerged as a revolutionary solution to combat the global shortage of organs. However, varying rejection patterns in multi-organ grafts remain a critical obstacle. The team's editing strategy, involving three knockouts and three insertions, is designed to reduce immune responses and improve compatibility, as noted in the study published in the journal MED.
Surgical Details
The liver and both kidneys were transplanted in their natural positions through a single incision. The total cold ischemia time, during which the organs were kept chilled outside the body, was controlled at 281 minutes from donor procurement to reperfusion. The recipient, a 53-year-old brain-dead man, was monitored for approximately 106 hours in an ethically approved clinical study conducted after his organs had been donated for clinical use.
Promising Outcomes
For about five days, the transplant showed promising physiological outcomes, including largely normal organ blood supply, as well as observed bile secretion and urine production. Examination of metabolites revealed that the pig liver was shifting its behavior to resemble a human liver rather than a pig one. This indicated that the organ managed to use the body's own resources and might even be able to completely reprogram its metabolism to match a human host.
The researchers stated that this study provides initial evidence for the feasibility of pig-to-human orthotopic whole-liver plus bilateral-kidney transplantation and identifies early immune and metabolic features that may inform perioperative management and future clinical translation.
Expert Commentary
Leonardo Riella, a physician scientist at Massachusetts General Hospital in Boston, commented that transferring multiple organs is more complex than moving one, and transplanting pig kidneys and a liver in the same procedure is unique. Wayne Hawthorne, a surgeon and transplant researcher at the University of Sydney, added that the study has shown that multi-organ xenotransplants are possible.
Limitations and Future Plans
The team acknowledged limitations, such as the short observation time influenced by the family's wishes and the need for better blood coagulation stability. Since chronic rejection and long-term durability have not been tested yet, they plan to carry out three to five more procedures to see if the results can be successfully reproduced.
Previous Achievements in China
Medical teams from China have previously performed multiple pig-to-human organ transplants. In February, another Chinese team used a gene-edited pig liver to treat a patient with acute liver failure, saving the patient's life and significantly improving key liver function indicators. Last October, Chinese surgeons announced the world's first transplant of a gene-edited pig liver into a living human patient, who survived for 171 days following the operation. There were also other advancements in 2025, including cases of pig lung and pig kidney transplants.
