Hey bacon breath: World’s first pig lung transplant

A lung from a genetically modified pig has been transplanted into a person for the first time. The recipient survived just 9 days. Is this a crucial step toward solving the global organ shortage crisis?

This little piggy went to hospital

A human has breathed with a pig’s lung for the first time. The recipient, a 39-year-old man in China, was brain dead, but the organ survived for nine days. 

This experiment at Guangzhou Medical University occurred in May 2024 but has just been released as a peer-reviewed article in Nature. It represents the latest frontier in xenotransplantation – transplanting organs between different species. 

The donor lung came from a gene-edited Bama miniature pig with six CRISPR modifications. Three pig genes were disabled to avoid immune activation. Three human genes were added to improve compatibility. 

Unlike previous pig organ transplants involving hearts and kidneys, lungs present unique challenges. They constantly interact with the external environment encountering dust, germs and other pollution, literally with every breath. 

Organ failure 

The global organ shortage is staggering. In the US, 13 people die daily waiting for transplants, with waiting lists twice as long as completed procedures. 

And that’s in the first world. According to the World Health Organisation's Global Observatory on Donation and Transplantation, only 10 percent of the global need for organ transplants is being met. 

Lung transplants are particularly challenging. A healthy kidney may last over a decade. A transplanted lung often survives just five to seven years.  

Lungs have the most blood vessels of any organ, making them prone to both external pollutants and internal immune system attacks. 

Sweet and sour  

There’s no sugar-coating this. The patient remained brain dead and died after nine days. 

The good news? The study claims no “hyperacute rejection” occurred. This is the violent, minutes-long immune assault that doomed earlier cross-species transplants. However, some experts remain unconvinced on this point. 

We do know that within 24 hours, CT scans revealed severe oedema – waterlogged, dense tissue inflamed by blood flow trauma. By day three, antibodies attacked the lung. Damage worsened on day six, before slight recovery by day nine. 

As transplant surgeon Dr Adam Griesemer bluntly put it: “Nobody would sign up for a nine-day lung transplant.” 

Bring home the bacon 

Despite challenges, experts remain cautiously optimistic. Dr Ankit Bharat from Northwestern Medicine noted this could be “a paradigm shift long term” if safety and efficacy can be established. 

The researchers themselves acknowledge the work ahead. As study co-author Dr Jiang Shi told STAT: “The aim of the study was to investigate how the human immune system might react to such a transplant, not to claim clinical readiness today.” 

Future improvements need better genetic modifications and refined anti-rejection drugs. 

Some scientists are exploring alternative approaches, such as using pig lungs as scaffolds for growing human tissue – essentially creating hybrid organs that are structurally pig but cellularly human. 

The bleeding obvious 

For all the advances in gene edited pigs’ lungs and other forms of xenotransplantation that we will one day hopefully make, the easiest way to put a massive dent in that waiting list right now is for everyone to consider nominating as an organ donor. 

Personally, I’d be cool with a system whereby as an over-18 you were assumed to opt in and had to choose not to donate. But I accept that’s too far for some people. 

Regardless, while 80% of Aussies say they support organ donation, only 36% nominate their own insides for reuse (Donate Life 2024 Donation and Transplantation Report). If only we could close that gap. 

You can sign up to the national organ donors register here

The breath of fresh air we need? 

This is both progress and a sobering reality check. 

While nine days might not sound like much, it’s significantly longer than the mere minutes that previous cross-species lung transplants survived. 

For the thousands waiting for donor organs worldwide, xenotransplantation offers hope that one day, the shortage of human organs won’t be a death sentence. 

We are years away from pig lungs becoming a clinical reality for living patients. 

Nevertheless, it’s a remarkable step forward in humanity’s quest to engineer our way out of one of medicine’s most persistent challenges. 

Keep breathing, 

Adam S