Core Viewpoint - The successful transplantation of a genetically edited pig kidney into a human patient, Tim Andrews, has set a new record for survival duration, lasting 271 days, highlighting advancements in xenotransplantation and its potential to address organ shortages [1][2]. Group 1: Medical Advancements - Tim Andrews underwent a pig kidney transplant on January 25, which was genetically edited to enhance compatibility and reduce rejection risks [1]. - The pig kidney was edited at 69 sites, including the removal of genes that cause rejection and the addition of human genes to improve compatibility [1]. - Despite the advancements, Andrews experienced rejection reactions and had to have the kidney removed after 271 days due to the side effects of immunosuppressive drugs [2]. Group 2: Global Research Efforts - The U.S. has seen multiple attempts at xenotransplantation, with previous cases of pig kidney transplants lasting less than two months before rejection [1]. - Chinese medical teams are also making strides in this field, with a successful pig kidney transplant that has functioned for over 200 days, marking a significant achievement in Asia [2]. - Other organs, such as pig hearts, lungs, and livers, are being explored for transplantation to address the organ shortage crisis [3]. Group 3: Ethical and Research Considerations - There are ongoing concerns regarding the long-term health impacts of animal organ transplants on humans, as well as the quality of life for recipients [3]. - The field of xenotransplantation raises ethical, anthropological, and sociological questions that need to be addressed to ensure responsible implementation [3].

Core Viewpoint - The primary motivation for xenotransplantation research is the shortage of human organs, with a focus on establishing a legal framework for organ donation and promoting voluntary, non-remunerated organ donation after death [1][11]. Group 1: Progress in Xenotransplantation - Significant milestones in xenotransplantation have been achieved in the past five years, including the first successful transplantation of genetically modified pig organs into human patients [6][7]. - The first case of a genetically modified pig kidney transplanted into a living human was reported, with the patient surviving for nearly eight months [6][8]. - The FDA has approved the first clinical trial for pig kidney transplantation, marking a regulatory advancement in the field [8][9]. Group 2: Challenges and Future Directions - Despite progress, xenotransplantation faces challenges such as long-term rejection reactions, biological compatibility issues, and the risk of viral infections from pig organs [15][16]. - The supply-demand ratio for organs in China is approximately 1:8, indicating a significant gap that xenotransplantation aims to address [11][13]. - There is a need for further research and clinical trials to ensure the safety and efficacy of xenotransplantation, particularly in the context of regulatory frameworks and patient selection criteria [8][11]. Group 3: Public Perception and Education - Public concerns regarding xenotransplantation include fears of changing human characteristics and potential disease transmission from pig organs [17]. - Efforts are being made to educate the public about the realities of xenotransplantation, emphasizing that pig organs are merely biological materials and do not alter human behavior [17]. - The promotion of knowledge about xenotransplantation is seen as essential to addressing the organ shortage crisis and advancing the field [17].

Core Viewpoint - The article discusses the successful transplantation of genetically edited pig lungs into a brain-dead human, marking a significant advancement in xenotransplantation, which aims to address the global organ shortage crisis [1][5][18]. Group 1: Background and Importance of Xenotransplantation - Approximately 2 million people worldwide require organ transplants each year, but only about 10% receive suitable organs, highlighting the critical shortage of transplantable organs [5]. - Xenotransplantation, particularly using pig organs, is considered a promising solution to the organ shortage problem [5][9]. Group 2: Research and Development - The research team led by Professor He Jianxing from Guangzhou Medical University successfully transplanted a genetically edited Bama pig's left lung into a brain-dead patient, maintaining ventilation and gas exchange for 9 days [5][18]. - Since 2021, several cases of pig-to-human organ transplants have been reported globally, involving various organs such as hearts, kidneys, and livers [7]. Group 3: Advantages of Using Pigs - Pigs are preferred over primates for organ donation due to their abundant resources, smaller size, high survival rates, and genetic stability, along with significant anatomical and physiological similarities to humans [9][10]. - The evolutionary distance between pigs and humans reduces the risk of zoonotic diseases and ethical concerns associated with using primates [9]. Group 4: Challenges in Xenotransplantation - Despite the advantages, xenotransplantation faces challenges such as cross-species rejection and the risk of infections, which have historically hindered research progress [10][18]. - Recent advancements in gene editing technologies, such as CRISPR/Cas9, have enabled the development of genetically modified pigs that minimize immune rejection and viral infection risks [10][12]. Group 5: Clinical Trials and Future Prospects - Currently, xenotransplantation trials are primarily conducted in China and the United States, with significant milestones achieved in heart and kidney transplants [14][16]. - The recent lung transplant case represents a critical step towards clinical applications, although experts emphasize the need for cautious progression through further trials and research [18][19].

Core Viewpoint - The article discusses significant advancements in xenotransplantation, particularly focusing on the successful transplantation of genetically edited pig organs into human patients, highlighting the potential to alleviate organ shortages in humans [3][4][5]. Summary by Sections Breakthroughs in Xenotransplantation - In October 2021, NYU Langone Medical Center performed the first transplantation of a genetically edited pig kidney into a brain-dead woman [3]. - In January 2022, the University of Maryland conducted the first live transplantation of a genetically edited pig heart, with the patient surviving for approximately two months [3]. Recent Research on Pig Lung Transplantation - In March 2025, a team from Xijing Hospital published a paper in Nature, reporting the first successful transplantation of a genetically edited pig liver into a brain-dead patient, with the organ functioning for 10 days [4]. - In August 2025, a study published in Nature Medicine documented the world's first successful transplantation of a genetically edited pig lung into a brain-dead human, with the lung surviving for 9 days and functioning properly [5][4]. Genetic Modifications and Challenges - The pig lung used in the transplantation was genetically modified by deleting three "dangerous" genes (GTKO, CMAH, B4GALNT2) and adding three protective human genes (hCD46, hCD55, hTBM) to mitigate immune rejection [7][9]. - During a 216-hour monitoring period, the transplanted pig lung maintained vitality and function without signs of hyperacute rejection or infection, although complications such as severe edema and antibody-mediated rejection were observed [9][10]. Future Directions and Considerations - The study indicates that further genetic modifications may be necessary to improve outcomes, particularly in addressing coagulation disorders and enhancing graft survival [11][12]. - The complexity of lung transplantation poses greater challenges compared to other organs, necessitating ongoing preclinical research to overcome these barriers [12]. China's Leadership in Xenotransplantation - Chinese scientists are at the forefront of xenotransplantation research, having completed the world's first human transplant of genetically edited pig liver and lung, as well as a kidney transplant with a patient surviving for nearly six months [12].