Lecture Code : PL03-S1
Session Name : Plenary Lecture 3
Session Topic : Plenary Lecture 3
Date & Time, Place : June 13 (Sat) / 10:20-11:40 / Auditorium, 3F

---

Xenotransplantation: Clinical Development and Challenges

Tatsuo Kawai
Massachusetts General Hospital / Harvard Medical School, United States

---

Xenotransplantation using organs from genetically modified pigs has emerged as a promising solution to the critical shortage of donor organs and has been actively investigated, primarily in preclinical animal studies. However, several major challenges must be overcome to achieve successful xenotransplantation, including rejection mediated by natural antibodies against xenogeneic antigens, activation of complement, coagulation, and inflammatory pathways due to functional incompatibilities of porcine proteins, and the risk of zoonotic infections. Since 2010, rapid advances in gene-editing technologies, particularly CRISPR-Cas9, have enabled the knockout of multiple porcine genes and the introduction of numerous human genes, leading to substantial improvements in xenograft outcomes. At Massachusetts General Hospital (Boston, USA), in collaboration with eGenesis, the world’s first clinical kidney xenotransplantation using a genetically modified pig was performed in 2024, and four clinical cases have been conducted to date. In this presentation, I will review the progress from preclinical studies to clinical application and discuss the remaining challenges and future perspectives.

Keywords: xenotransplantation, kidney transplantation, gene edits, organ shortage, pigs