Challenges and opportunities of liver xenotransplantation

Organ transplantation is the most effective treatment for end-stage organ failure. However, donor shortage leads to many patients dying while waiting for transplants. With breakthroughs in basic research,advancements in gene editing technologies,and developments of new immunosuppressive drugs,xenotransplantation is regarded as the most promising solution to address the organ shortage crisis. In recent years, researchers both domestically and internationally have conducted multiple studies on non-human primates (NHPs), brain-dead donors,and patients with end-stage heart failure, end-stage renal disease, and advanced liver cancer. Nevertheless, challenges such as immune rejection and coagulation dysfunction continue to limit recipient survival, hindering significant breakthroughs in the clinical application of xenotransplantation. This review summarizes the latest developments in xenotransplantation research globally, with a focus on immune rejection and coagulation dysfunction following liver xenotransplantation.