Evidence map›Paper›PMID 41663593›Full record

ArticleNature medicine2026

Extracorporeal liver cross-circulation using transgenic xenogeneic pig livers with brain-dead human decedents.

Abraham Shaked, Alex Sagar, Kim M Olthoff, Peter L Abt, Emily A Vail, Niels D Martin, Charles S Abrams, Rick D Hasz, Christine Radolovic, Shannon Kaminski and 16 more

Abstract read
PubMed Publisher
In one paragraph

Article in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
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  3. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Abraham Shaked *Penn Transplant Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. abraham.shaked@uphs.upenn.edu.ORCID http://orcid.org/0000-0002-2162-095X
Alex Sagar *Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Kim M OlthoffPenn Transplant Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Peter L AbtPenn Transplant Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Emily A VailDepartment of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0002-1849-5780
Niels D MartinDepartment of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0002-2157-0825
Charles S AbramsHematology-Oncology Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Rick D HaszGift of Life Donor Program, Philadelphia, PA, USA.
Christine RadolovicGift of Life Donor Program, Philadelphia, PA, USA.
Shannon KaminskiGift of Life Donor Program, Philadelphia, PA, USA.
Bao-Li LozaPenn Transplant Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0003-3917-6129
James F MarkmannPenn Transplant Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0002-2762-6535
Susan C LoweGenesis, Cambridge, MA, USA.
Mike CurtiseGenesis, Cambridge, MA, USA.
Leanne LanierieGenesis, Cambridge, MA, USA.
Kirsten G SwensoneGenesis, Cambridge, MA, USA.
Gregory T EversonHepQuant, LLC, Denver, CO, USA.
David A WagnerMetabolic Solutions Inc, Nashua, NH, USA.
Mohamed A ElzawahryNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0001-5300-912X
John I FallonNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-8644-9380
Syed Hussain AbbasNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Danielle FortunaDepartment of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Emma E FurthDepartment of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
K Rajender ReddyPenn Transplant Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0002-4898-7778
Peter P Reese *Penn Transplant Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Peter Friend *Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-0841-9685

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Extracorporeal liver cross-circulation (ELC) using genetically modified pig livers may address an unmet need for temporary liver support in patients with acute or acute-on-chronic liver failure. This study used the ELC platform to evaluate early immune responses and assess xenogeneic liver physiological support in a human decedent model. Four human decedents underwent ELC using pig livers with a triple glycan knockout; insertion of seven human transgenes and inactivation of pig endogenous retroviruses. Intravenous methylprednisolone was administered for immunosuppression. In the case of decedents 1-3, ELC was performed for 72-84 h with the native livers of the decedents remaining in situ. In the case of decedent 4, hepatectomy was performed, followed by 48 h of xenogeneic liver support exclusively using ELC. Biopsies of xenogeneic livers demonstrated preserved parenchymal architecture, mild immune infiltration and IgM deposition. Xenogeneic livers produced bile and supplemented native hepatocellular function. In decedent 4, xenogeneic liver-only support after hepatectomy maintained hemodynamic stability, normal pH, lactate, ammonia, international normalized ratio and sustained metabolic function. This study shows that ELC is feasible using xenogeneic livers with minimal immunosuppression and can provide effective liver support.

Indexed as

Brain DeathExtracorporeal CirculationLiverAnimalsAnimals, Genetically ModifiedEndogenous RetrovirusesFemaleGalactosyltransferasesHepatectomyHumansLiver TransplantationMaleSwineTransplantation, HeterologousGalactosyltransferasesN-acetyllactosaminide alpha-1,3-galactosyltransferase

Identifiers

PMID41663593

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.