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World first: living cancer patient in China receives pig’s liver transport

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World first: living cancer patient in China receives pig’s liver transport

In a world first, Chinese doctors said they transplanted a gene-edited pig’s liver into a living patient, the latest milestone in a record-setting year for researchers into animal-to-human transplants, known as xenotransplantation.
In a post on its WeChat account on Friday, seven days after the operation, Anhui Medical University’s First Affiliated Hospital said a 71-year-old man with severe liver cancer received the organ on May 17.

As of May 24, “the patient was able to walk freely, no hyper-acute or acute rejection reactions were found, the coagulation system was not impaired, and liver function had returned to normal”, the university said.

The achievement follows another breakthrough in March, by a Chinese team from Air Force Medical University that transplanted the first gene-edited pig’s liver into a patient who had suffered brain death.
Also in March, a patient in the United States became the first in the world to receive a genetically modified pig’s kidney transplant, a procedure previously performed only on clinically dead patients.

The patient, who had been suffering end-stage kidney failure, died suddenly earlier this month. Massachusetts General Hospital in Boston, where the procedure was carried out, said there was “no indication” that his death was due to the transplant.

A second US patient, who received a gene-edited pig’s kidney in April, is still alive and “brings hope for the development of xenotransplantation from pigs to humans”, Anhui Medical University said.

But the complexity of the liver – which plays a role in major bodily functions like metabolism and immunity – poses a greater challenge than kidneys and hearts, leading US researchers to suggest that its function “is too powerful” for xenotransplantation, Anhui Medical University said.

The latest feat indicated that “Chinese scientist’s xenotransplantation technology has reached the forefront of the world and will become one of the most important breakthroughs in the medical field”, it said.

China’s organ transplant ethics committee approved the study because the patient had a large tumour in the right lobe of his liver that was not responding to other treatment and posed a rupture risk.

The 71-year-old cancer patient (third from left, with features obscured) with the medical team after the surgery that made him the first living patient to receive a genetically modified pig’s liver. Photo: First Affiliated Hospital of Anhui Medical University

The 514 gram (18 oz) pig’s liver, which contained 10 gene edits to prevent organ rejection and dysfunction, was transplanted into the patient after doctors confirmed the left lobe of his liver was unable to provide sufficient function on its own.

“Currently, the transplanted pig liver secretes about 200ml (nearly 7 fl oz) of golden bile every day,” said the hospital’s director Sun Beicheng, according to a report by People’s Daily.

Sun said that scans confirmed “the blood flow in the hepatic artery, portal vein and hepatic vein of the transplanted pig liver is completely normal” a week after the surgery.

According to the university, the success of this operation will make it possible “for xenotransplantation of pig liver to enter the clinic”.

The recent successes of Chinese and US researchers have raised hopes that transplants of genetically edited organs from pigs could offer a solution to global organ shortages, with demand greater than the supply of human organs.

But despite the progress in xenotransplantation of recent years, there are still ethical concerns surrounding the practice, including the possibility of organ rejection and the potential for disease transmission.

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