The organ shortage has a supply problem. Biotech's solution is getting extremely literal.

If your phone dies, you buy another one.

If your kidney dies, logistics get slightly more complicated.

You may need dialysis. You may need a transplant. And then you need something science has historically struggled to manufacture:

another human kidney.

In the US alone, about 95,000 people are currently waiting for one.

So scientists have proposed a fairly wild solution.

What if your replacement kidney doesn't come from a human at all?

What if it comes from a pig?

Because this has officially moved beyond weird laboratory experiment territory.

A formal clinical trial called EXPAND is now testing genetically edited pig kidneys in living people with end-stage kidney disease. The first transplant in the trial was performed at NYU Langone in late 2025.

If this eventually works safely at scale, organ transplantation could stop depending entirely on another human having a spare organ at exactly the right time.

That's a ridiculous sentence.

It's also increasingly real.

Turns out pigs have been carrying around suspiciously useful kidneys.

They're similar to ours in size and function, and scientists can genetically modify them before they're born.

There is one small problem.

Your immune system is basically a nightclub bouncer with an extremely strict guest list.

Human kidney?

Maybe.

Pig kidney?

Absolutely not, mate.

So the kidney being tested in EXPAND has 10 genetic edits.

Scientists added six human genes designed to improve compatibility and switched off four pig genes associated with rejection and excessive organ growth.

They aren't turning the pig kidney into a human kidney.

They're essentially trying to make it less biologically offensive to your immune system.

Modern medicine is strange.

We have very much not solved this yet.

Before the formal trials began, some patients received pig kidneys through special compassionate-use programs.

One recipient, Towana Looney, lived with a gene-edited pig kidney for 130 days before doctors had to remove it after signs of rejection. She returned to dialysis.

So these kidneys are not sitting on a supermarket shelf between bacon and ibuprofen.

Researchers still need to figure out:

Can they work for years?

Can rejection actually be controlled?

Are they safe long-term?

That's what the trials are for.

For almost the entire history of organ transplantation, we've treated this as a supply problem:

There aren't enough human donors.

So we encouraged more humans to donate.

Built better transplant networks.

Improved preservation.

Made waiting lists.

Biotech is now asking a completely different question.

We spent decades trying to make more humans into organ donors.

Now we're trying to make organ donors that aren't human.

The pig did not consent to this career pivot.

The monkey has questions.