howclose.to
Biology & Health · Updated July 2026Momentum · accelerating

How close are we to transplanting animal organs into people?Can animal organs save people on the transplant list?

or, simply: Can animal organs save people on the transplant list?or, precisely: How close are we to transplanting animal organs into people?

Gene-edited pig organs have kept people alive for months; the open question is whether they can replace human donors for years, not weeks.Thousands die waiting for organs. Gene-edited pig kidneys and hearts could close the gap - if they last.

We are here

Controlled trials, sparse outcomes - EXPAND targets 50 participants, but no cohort-level 24-week survival distribution has yet been posted; 271 days remains the completed record. Next up - EXPAND primary completion target (expected Oct 2028).

01 · Where we stand

State of playWhere xenotransplant stands right now

The current stage, the honest metric, and the single threshold that gates the next stage. Each threshold is a falsifiable claim with a named next test.How far up the ladder we've climbed, the honest verdict, and the one thing blocking the next step.

The five stagesMaturity ladder
Deployed
Out in the real worldDeployed at scale
Scaling
Making it cheap enough at scaleScaling toward competitive cost
Engineering← HERE
Building one that pays for itselfEngineering a system that pays back
Lab demo
Shown to work in a labDemonstrated in the laboratory
Theoretical
The idea is worked out on paperTheoretical basis established
The honest verdictVerified state

Thousands die waiting for organs. Gene-edited pig kidneys and hearts could close the gap - if they last.Gene-edited pig organs have kept people alive for months; the open question is whether they can replace human donors for years, not weeks.

271Best result so farTim Andrews; graft explanted after declining function
365Initial one-year durability
Blocking the next stepBlocking threshold

Last a full yearSustain one dialysis-free year Next test: Publish a verified 365-day graft-function result, including GFR, rejection episodes and immunosuppression.

The verdict, in five rungsHow far up the ladder↓ next — the thresholds & the gap
01 · The evidence

The thresholds that gate the next stageWhat has to happen next

Each threshold is a falsifiable claim with a named next test; the gap chart shows how far today's metric sits from the goal.Each row is one thing that has to be proven — and how far today's number is from the target.

Avoid immediate immune destructionSurvive the first attack✓ Achieved · Sep 2021
100%
Proven byA single-edit kidney functioned through NYU's 54-hour brain-dead-body study.
Replace dialysis in a living personGo home without dialysis✓ Achieved · Apr 2024
100%
Proven byRichard Slayman was discharged 18 days after transplant and lived 52 days with the graft.
Sustain one dialysis-free yearLast a full yearIn progress
74%
Next testPublish a verified 365-day graft-function result, including GFR, rejection episodes and immunosuppression.
Produce a survival distributionProve it across a groupEarly
10%
Next testThe six-person EXPAND cohort reaches at least 12 weeks and undergoes independent safety review, followed by 24-week endpoint reporting.
THRESHOLDS - Thresholds for Xenotransplant.
Scale
Dialysis-free functional pig-kidney graft survival in living recipients over time, with measured values, projected values, and a goal at 365 days.050100150200250300350Dialysis-free functional pig-kidney graft survival in l… · daysYear202420252026GOAL 365 · Initial one-year durabilityRichard Slayman; 52 days wi…Bill Stewart; at least 250…~115 days to goal
NOTE - This carries forward the candidate node's recommended metric. Values are individual cases, not a survival curve: compassionate-use recipients differed sharply in illness, donor edits and immunosuppression. Stewart's 250-day point is a published minimum while ongoing, not a final outcome. The one-year line is an editorial near-term goal; the candidate node's ten-year mature benchmark is deliberately not plotted because it is aspirational, not a dated forecast. Brain-dead-body experiments are excluded because they cannot establish recipient survival or durable clinical independence from dialysis.
02 · How we got here

The record behind the verdict

Major events set large; context events set small but never hidden. Everything below the TODAY rule is a schedule, not a result.

1906-19621 event1 shown

Borrowed Organs, Blind Immunity

Borrowed Organs, Blind Immunity begins with first vascular organ attempts. The result established the next question for the field.

1906
First vascular organ attemptsExperiment
Mathieu Jaboulay attached pig and goat kidneys to two women; both grafts failed within days.
1963-19962 events0 shown

Primate Grafts and Rejection

Primate Grafts and Rejection moved the field from chimp kidneys reach nine months to baby fae survives 21 days. The results narrowed the next question without closing it.

1963
Chimp kidneys reach nine months
Reemtsma transplanted chimpanzee kidneys into 13 patients; one recipient returned to work and survived nearly 9 months.
1997-20143 events1 shown

Virus Risk Meets Gene Editing

Virus Risk Meets Gene Editing moved the field from pig retrovirus infects human cells to who sets trial principles. The results narrowed the next question without closing it.

1997
Pig retrovirus infects human cells
Researchers showed porcine endogenous retrovirus could infect human cells in vitro, elevating population-level infection concerns.
2015-20203 events0 shown

Preclinical Barriers Begin Falling

Preclinical Barriers Begin Falling moved the field from crispr disables 62 perv copies to life-supporting hearts pass six months. The results narrowed the next question without closing it.

2021-207520 events4 shown

Humans Enter Controlled Trials

Humans Enter Controlled Trials moved the field from gene-edited kidney enters human body to expand primary completion target. The results narrowed the next question without closing it.

2021
Gene-edited kidney enters human bodyExperiment
An alpha-Gal-knockout pig kidney made urine without hyperacute rejection during a 54-hour brain-dead-body study.
2023
Decedent kidney runs 61 days
A single-edit pig kidney functioned for 61 days; dense sampling later mapped about 5,100 human and pig genes during rejection.
2023
Second pig heart rejected
Lawrence Faucette died 40 days after transplant; the heart performed well for one month before showing rejection.
2024
Pig liver is implanted in a human body
A six-edit auxiliary liver produced bile and porcine albumin during a planned ten-day brain-dead-recipient study; the native human liver remained.
2024
Combined transplant ends at 47 days
Lisa Pisano's single-edit pig kidney was removed after 47 days following hypotension-related damage; she died six weeks later.
2024
Pig liver and kidneys work together
A whole liver and both kidneys from one six-edit pig supported a brain-dead recipient for nearly five days; this was physiology testing, not recipient survival.
2024
Looney reaches 130 days
Towana Looney lived dialysis-free for 130 days; acute rejection followed reduced immunosuppression for an unrelated infection.
2025
Asian pig-kidney case reaches 261 days
A six-edit kidney transplanted into a living recipient functioned for 261 days before deterioration and complications led to removal and resumed dialysis.
2025
First controlled kidney trial startsDeployment
EXPAND transplanted its first participant and opened a six-person first cohort, with 24-week safety and efficacy endpoints.
2026
Pig kidney bridges to human transplant
After his 271-day pig graft and return to dialysis, Tim Andrews received a human donor kidney, demonstrating practical bridge feasibility.
2026
Controlled trials, sparse outcomesDeploymentWe are here
EXPAND targets 50 participants, but no cohort-level 24-week survival distribution has yet been posted; 271 days remains the completed record.
2028
EXPAND primary completion targetDeploymentTarget
The 50-participant EXPAND registry record estimates primary completion in October 2028; this is scheduled, not achieved.
2075-20751 event0 shown

Events outside the declared eras

Events outside the declared eras begins with lifetime surveillance horizon. The result established the next question for the field.

2075
Lifetime surveillance horizonDeploymentTarget
EXPAND lists study completion in 2075 because recipients require lifelong graft and zoonotic-infection follow-up.
— end of record · 30 shown, 0 hidden —
30 events · below the TODAY rule = scheduled, not done
03 · The data behind the verdict

Why the meters read the way they do

The learning curves and comparisons that justify each threshold's percentage. Every series is measured, with the source event linked in the timeline above.

5 people. No survival curve yet.5 living recipients; best completed 271-day survival, one ongoing (right-censored); goal 365 days.One bar = one living recipient · dialysis-free graft survival · days · 2024–2026 · dashed hollow = ongoing minimumOne bar = one living recipient · dialysis-free graft survival in days · 2024–2026 · solid grey = completed record, accent = best completed, dashed hollow = ongoing right-censored minimum · goal = Initial one-year durability
Living-recipient pig-kidney graft survival staircaseEach bar is an individual living-recipient case. Completed records are grey, the best completed record is the accent protagonist, and ongoing results are hollow with dashed outlines because their published values are right-censored minimums. The goal is 365 days.TARGET · Initial one-year durability · 365 days0197.1394.2522024472024130202527120252502026ONGOING · MINIMUMBEST COMPLETED OBSERVATION271 DAYS · COMPLETED RECORD94 days left
EGENESIS · NYU LANGONE · AP · AS OF JUL 2026
Observation windows expanded from 54 hours to 61 days, enabling richer physiology and rejection sampling, but these models are not clinical survival evidence.
Observation windows expanded from 54 hours to 61 days, enabling richer physiology and rejection sampling, but these models are not clinical survival evidence.010203040506070Brain-dead human kidney-study duration · daysYear20212022202361 days
NOTE - Observation windows expanded from 54 hours to 61 days, enabling richer physiology and rejection sampling, but these models are not clinical survival evidence.
The 945-day heterotopic result did not support life; the more stringent orthotopic, life-supporting model reached 195 days, so this is a model comparison, not a declining trend.
The 945-day heterotopic result did not support life; the more stringent orthotopic, life-supporting model reached 195 days, so this is a model comparison, not a declining trend.02004006008001,000Selected pig-heart survival in baboons · daysYear20162018195 days
NOTE - The 945-day heterotopic result did not support life; the more stringent orthotopic, life-supporting model reached 195 days, so this is a model comparison, not a declining trend.
Engineering breadth increased, but edit count is not a performance score: competing clinical programs still test 10-edit and 69-edit kidneys.
Engineering breadth increased, but edit count is not a performance score: competing clinical programs still test 10-edit and 69-edit kidneys.010203040506070Maximum donor-pig genome modifications used in a hu… · genome modificationsYear20212022202469 genome modifications
NOTE - Engineering breadth increased, but edit count is not a performance score: competing clinical programs still test 10-edit and 69-edit kidneys.
  • People waiting for a kidney90400 people
  • Kidney transplants performed in 202427759 transplants
COMPARISON - The U.S. kidney waiting list is more than three times annual kidney transplant volume.
  • Completed record271 days
  • Initial durability goal365 days
COMPARISON - The completed living-recipient record has covered about three quarters of the first one-year durability target.
  • eGenesis EGEN-278469 genome modifications
  • United Therapeutics UKidney10 gene edits
COMPARISON - Two kidney programs are testing radically different genome-engineering strategies; more edits are not proven better.
  • Heterotopic baboon record945 days
  • Orthotopic life-supporting record195 days
COMPARISON - A non-life-supporting heart model lasted far longer than the stricter replacement-heart model.
Technical notes

Read the evidence more closely

Definitions, system boundaries and experimental caveats behind the headline record.

01What the 69 edits comprise

The “69 edits” in EGEN-2784 are not 69 compatibility genes: they comprise three glycan-antigen knockouts, seven human transgenes and inactivation of 59 porcine endogenous-retrovirus sequences. Slayman experienced biopsy-confirmed T-cell-mediated rejection on day 8, reversed with intensified immunosuppression; autopsy found no evident graft rejection when he died on day 52.

02The 61-day study showed delayed rejection

The 61-day NYU decedent study detected antibody-mediated rejection at postoperative day 33 and combined antibody- and T-cell-mediated rejection by day 49, despite avoiding hyperacute rejection. That is mechanistic evidence of delayed immune escape, not 61 days of rejection-free function.

03The auxiliary liver did not work alone

The ten-day auxiliary liver produced only 66.5 ml cumulative bile by day 10 and detectable porcine albumin. Because the native human liver remained, the experiment did not show that the pig graft could independently sustain life.

04Microangiopathy ended the living liver trial

In the living liver recipient, early biopsies showed no hyperacute or acute rejection, but xTMA emerged around day 31 with complement activation, hemolysis, thrombocytopenia and organ dysfunction. Eculizumab and plasma exchange were insufficient until the graft was removed on day 38.

05The lung sustained severe early injury

The lung graft avoided hyperacute rejection and infection for 216 hours, but severe edema resembling primary graft dysfunction appeared at 24 hours; antibody-mediated rejection contributed to injury on days 3 and 6, with only partial recovery by day 9. The recipient’s right human lung remained.

06Short liver support coexisted with injury

Four extracorporeal liver experiments ran 72-84 hours with native livers present; one hepatectomized decedent received 48 hours of support from the pig liver alone. Preserved architecture and bile production coexisted with IgM deposition, immune infiltration and severe thrombocytopenia.

07The multi-organ study tested physiology

The 2026 multi-organ experiment found no hyperacute rejection during the first 24 hours, but early immune injury appeared after roughly 36 hours. Its approximately 106-hour observation window tests physiology and liver-kidney immune interactions, not recipient survival.

08Edit count is not an efficacy score

Competing kidney platforms remain genuinely different hypotheses: United Therapeutics uses ten edits, whereas eGenesis uses 69 genomic modifications. Edit count should not be treated as an efficacy score; only comparative cohort outcomes can establish which design performs better.

04 · What it unlocks

If the remaining tests pass

Downstream capabilities, drawn dashed because they depend on results not yet in.

XenotransplantAn expandable organ supplyPurpose-bred donor herds could replace today's dependence on scarce, unpredictable human donations.Earlier treatment of organ failurePatients could receive a planned transplant before years of dialysis or terminal decline make surgery riskier.Bridges to human transplantsEven initially time-limited pig organs could buy months or years until a matched human organ becomes available.A replaceable organ supplyOn-demand transplant organs remove one of the hard limits on a long, healthy life.
05 · The players & the money

Who is building it-and what the money saysCapital, institutions and the global race

The teams doing the work, where they are based, and whether the money points to real delivery or only a plan.Company finance, public programmes, institutional leadership and market evidence-kept separate from valuations, forecasts and announced capacity.

The short versionCapital and institutional readout

Two US organ-engineering programs have moved gene-edited pig kidneys into regulated clinical studies, while Chinese teams have broadened the organ types tested. The unmet need is enormous, but the human evidence is still a handful of recipients and small planned trials. Authorization, survival for months and capital raised are not the same as durable safety, efficacy or approval.

Players

Who is building itCompanies, laboratories and programmes

eGenesis

USA

Engineers multi-edited porcine kidneys, livers and other organs

United Therapeutics / Revivicor

USA

Supplies the 10-gene-edited UKidney used in the EXPAND clinical trial

NYU Langone Transplant Institute

USA

Clinical center for EXPAND and earlier decedent and living-recipient xenokidney studies

Companies, laboratories and programmes working on this problem
PlayerCountryWhat they are doingFundingNamed investorsSource
eGenesiscompanyUSA

Engineers multi-edited porcine kidneys, livers and other organs

Series D · $191M · Sep 2024Lux Capital · ARCH Ventures · Khosla Ventures · Fresenius Medical Care Ventures · Leaps by Bayer · DaVitaSource · egenesisbio.com
United Therapeutics / RevivicorcompanyUSA

Supplies the 10-gene-edited UKidney used in the EXPAND clinical trial

A registered trial is not product approval.

Not disclosedNot disclosedSource · clinicaltrials.gov
NYU Langone Transplant InstitutelabUSA

Clinical center for EXPAND and earlier decedent and living-recipient xenokidney studies

Not disclosedNot disclosedSource · nyulangone.org
Massachusetts General HospitallabUSA

Clinical center for eGenesis expanded-access kidney recipients and planned clinical study

Not disclosedNot disclosedSource · egenesisbio.com
eGenesis / OrganOxcompanyUSA / UK

Developing temporary external pig-liver perfusion support for acute-on-chronic liver failure

The cleared study is external perfusion, not an implanted replacement liver.

Not disclosedNot disclosedSource · egenesisbio.com
Xijing Hospital / ClonOrganlabChina

Reported a six-gene-edited pig-liver study in a brain-dead recipient

Ten-day mechanistic experiment with the recipient's original liver retained.

Not disclosedNot disclosedSource · nature.com
06 · Sources

Where every number comes from

10 sources — every figure on this page traces to one.