Mapping the Evolution of Solid Organ Xenotransplantation Research:A Systematic Review

Ivana Juric; Marc Raynaud; Lea Skoric; Solaf Al-Awadhi; Agathe Truchot; Marta Sablik; Xiaoqian Ma; Kaikai Lv; Huanxi Zhang; Kevin Louis; Nikolina Basic-Jukic; Renaud Tissier; Thierry Hauet; Emanuele Cozzi; Gabriel C Oniscu; Massimo Mangiola; Joseph A Tector; Leonardo V Riella; Jayme E Locke; Didier Samuel; Raphael P H Meier; Muhammad M Mohiuddin; Robert A Montgomery; Alexandre Loupy

doi:10.1111/xen.70058

Mapping the Evolution of Solid Organ Xenotransplantation Research:A Systematic Review

Xenotransplantation. 2025 May-Jun;32(3):e70058. doi: 10.1111/xen.70058.

Authors

Ivana Juric^{1

2}, Marc Raynaud¹, Lea Skoric³, Solaf Al-Awadhi⁴, Agathe Truchot¹, Marta Sablik¹, Xiaoqian Ma⁵, Kaikai Lv⁶, Huanxi Zhang⁶, Kevin Louis^{1

7}, Nikolina Basic-Jukic², Renaud Tissier⁸, Thierry Hauet⁹, Emanuele Cozzi¹⁰, Gabriel C Oniscu¹¹, Massimo Mangiola^{12

13}, Joseph A Tector¹⁴, Leonardo V Riella^{15

16}, Jayme E Locke¹², Didier Samuel¹⁷, Raphael P H Meier¹⁸, Muhammad M Mohiuddin¹⁸, Robert A Montgomery^{12

19}, Alexandre Loupy^{1

20}

Affiliations

¹ INSERM, PARCC, Paris Institute for Transplantation and Organ Regeneration, Université de Paris Cité, Paris, France.
² Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center, Zagreb, Croatia.
³ Medical School, University of Zagreb, Zagreb, Croatia.
⁴ Department of Surgery and J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas, USA.
⁵ Institute for Cell Transplantation and Gene Therapy, the 3rd Xiangya Hospital of Central South University, Changsha, China.
⁶ Organ Transplant Center, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
⁷ Kidney Transplant Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
⁸ Ecole Nationale Vétérinaire d'Alfort, IMRB, AfterROSC, Maisons-Alfort, France.
⁹ Université de Poitiers, INSERM IRMETIST U1313, CHU de Poitiers, Service de Biochimie, Poitiers, France.
¹⁰ Transplant Immunology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University, Hospital-Ospedale Giustinianeo, Padova, Italy.
¹¹ Department of Clinical Science, Transplantation Surgery Division, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
¹² NYU Langone Transplant Institute, NYU Langone Health, New York, New York, USA.
¹³ Department of Pathology, NYU Grossman School of Medicine, New York, New York, USA.
¹⁴ Department of Surgery, University of Miami School of Medicine, Miami Transplant Institute, Miami, Florida, USA.
¹⁵ Transplant Center, Massachusetts General Hospital, Boston, USA.
¹⁶ Harvard Medical School, Boston, USA.
¹⁷ Centre Hépato-Biliaire, Hôpital Paul-Brousse, Université Paris-Saclay, Inserm Research Unit 1193, Villejuif, France.
¹⁸ Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
¹⁹ Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
²⁰ Department of Kidney Transplantation, Necker Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.

PMID: 40551623
DOI: 10.1111/xen.70058

Abstract

Introduction: Xenotransplantation has emerged as a promising solution to organ shortage, generating numerous publications. However, no studies have analyzed the research dynamics of xenotransplantation research. We aimed to systematically assess xenotransplantation publication activity.

Methods: A systematic literature search was conducted up to November 22, 2024. Studies on xenotransplantation of solid organs and islets of Langerhans from animals to humans, or perfusion with human blood or its derivatives were included. Publication information, publishing journal, publication type, organ, donor species, and topics studied were extracted.

Results: Of 2944 publications, 706 met inclusion criteria: 41.2% original articles, 41.1% reviews, 14.2% publications without original data, 1.6% case reports, 1.3% research letters, 0.6% systematic reviews/meta-analyses. Publication activity displayed two peaks: in the 1990s, driven by the gene editing advancements, and in the early 2020s, following the first pig-to-human transplantation. The top five publishing countries were the USA with (48.2%), Germany (10.2%), UK (5.4%), Sweden (4.8%), and China (4.2%). Xenotransplantation journal accounted for 19.7% of publications, transplantation journals for 27.6%, and general medical journals for 5.4%. Islets of Langerhans were studied in 23.1% of studies, and the most studied organs were heart (21.2%), followed by kidney (17.1%), liver (12.2%), and lung (6.2%). The most represented thematic groups were rejection, immune mechanisms, overall challenges, gene editing, current research, and prospects.

Conclusion: This first systematic assessment of xenotransplantation research highlights its growing global interest and evolving focus areas. The low proportion of publications with original data underscores the need for more original research. Limited representation in general medical journals highlights the importance of engaging a broader audience as clinical trials approach.

Keywords: publication activity; research trends; systematic review; transplantation; xenotransplantation.

Publication types

Systematic Review

MeSH terms

Animals
Biomedical Research*
Heterografts*
Humans
Organ Transplantation* / methods
Organ Transplantation* / trends
Swine
Transplantation, Heterologous* / methods
Transplantation, Heterologous* / trends