Are pig organs the future of transplantation?

Every living creature
Joshua D. Mezrich
The MIT Press, $29.95

Today, more than 100,000 people in the United States are waiting for an organ transplant. They are looking for kidneys, livers, hearts and lungs – organs from human donors that could give these patients a second chance at life. But every year, nearly 5,000 people on the national transplant list die waiting.

There is, however, a future in which no one will need to wait: when doctors have enough organs for every patient who needs them. These organs will come from genetically modified pigs, and they could be even better than the ones we were born with: resistant to cancer and infections and able to tolerate extreme temperatures and pressures. In this future, drones could crisscross the skies to transport custom-made pig organs directly to surgeons while they wait to be plugged into patients’ bodies.

“This may sound far-fetched and futuristic, but it really isn’t,” writes transplant surgeon Joshua Mezrich. His new book, Every living creaturetells the story of xenotransplantation, the practice of moving organs or tissues from one species into the body of another. If doctors can make it work, xenotransplantation could one day help meet a critical need, by increasing the number of organs available for transplantation.

In any case, this is the case for Mezrich. Amid optimistic prospects for the future of xenotransplantation, he takes the science seriously. This is a book that immerses readers in the vast ocean of transplant-related immunology. It offers intensive courses on the genetics, history and ethics of using animals to grow organs for humans. It features a wide range of characters in the field: surgeons and scientists, patients and funders. At times the story can feel like a whirlwind, carrying readers through decades and from laboratory to laboratory and from surgery to surgery. But basically, Every living creature is a book about hope.

These are doctors who have the determination and perseverance to keep going when the idea of ​​putting pig organs into living human beings seemed impossible. These are patients who endure months and years of daily dialysis while waiting for a kidney. These include people who desperately need a new heart but are too sick to be put on the list and people whose organs have ongoing problems but are not problematic enough to receive a new one.

It is also the story of courageous people who volunteer for experimental surgeries. People like David Bennett, the 57-year-old Maryland man who received a pig’s heart in 2022. Or Lawrence Faucette, 58, also from Maryland, who underwent a similar operation in 2023. These men were the first to have genetically modified pig hearts transplanted. Bennett survived for two months after the operation, and Faucette for almost six weeks. Both of these patients knew full well that their xenografts would likely not prolong their lives in the long term. But they signed up anyway because they hoped doctors could learn enough from their cases to help future patients. Stories like these give Mezrich’s book emotional weight and ground high-flying scientific aspirations in reality.

Mezrich calls himself a “xeno-optimist,” although he acknowledges that the field is prone to hype. Great technological advances have been necessary to successfully integrate a pig organ into a human being for decades, he writes. But that doesn’t mean that science hasn’t already made progress or that the goals will always be out of reach.

We’ve already seen progress beyond what doctors achieved with Bennett and Faucette. For example, Tim Andrews was 66 years old when he received a genetically modified pig kidney in 2025. Andrews lived with the organ for nearly nine months before it failed, and he was able to obtain a human kidney when it became available in January. In his case, the pig organ helped serve as a bridge to human organ transplantation.

The road ahead is strewn with pitfalls. Scientists must improve genetically modified organs so that the human body can tolerate them better. And biotech companies specializing in pig organs need to expand their agricultural facilities. But Mezrich predicts more xenotransplants like Andrews’ in the years to come. He envisions a day – perhaps not long before – when life-saving pig organ transplants will have become the norm. “Welcome to the future,” he said.

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