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Cardiac xenotransplantation: From imagination to achievable practice
Cai-Hong Wan, Department of Extracorporeal Circulation and Mechanical Circulation Assistance, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Bo-Yi Zhou, Yu-Long Guan, Department of Extracorporeal Circulation, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
Co-first authors: Cai-Hong Wan and Bo-Yi Zhou.
Author contributions: Wan CH and Zhou BY drafted the article and contributed equally to this work, have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper; Guan YL performed the final reviewing and editing; all authors read and approved the final manuscript.
AI contribution statement: During the preparation of this work the authors used DeepSeek-V3.1 in order to check spelling and grammar. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.
Conflict-of-interest statement: The authors declare no conflict of interest.
Corresponding author: Yu-Long Guan, MD, Professor, Department of Extracorporeal Circulation, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China.
Received: July 2, 2026
Revised: July 30, 2026
Accepted: August 20, 2026
Published online: August 26, 2026
Processing time: 56 Days and 21.2 Hours
Revised: July 30, 2026
Accepted: August 20, 2026
Published online: August 26, 2026
Processing time: 56 Days and 21.2 Hours
Core Tip
Core Tip: Cardiac xenotransplantation has advanced from the failed animal-heart attempts of 1964-1984 to two landmark first-in-human compassionate-use transplants of 10-gene-edited pig hearts in 2022 and 2023. Although both recipients died within 40-60 days, these proof-of-concept cases defined the key remaining barriers-antibody-mediated injury, porcine viral reactivation, and diastolic dysfunction-that must be resolved before gene-edited pig hearts may be explored in the further clinical trials and act as one of reliable and effective means for the treatment of end-stage heart failure.