A new Nature Biomedical Engineering study demonstrates that human kidney organoids can survive, integrate, and function within pig kidneys for 24 to 48 hours with no significant immune rejection or toxicity, signaling a potential pathway for organ regeneration or repair before transplantation.

The experiments combined ex vivo organ perfusion and in vivo transplantation within the same animals, using normothermic perfusion to keep organs oxygenated and viable outside and inside the body.

Thousands of stem-cell–derived kidney organoids were created with a scalable production method and infused into pig kidneys kept alive ex vivo to monitor real-time integration and function.

Key researchers emphasized that the work could help repair or prep organs before transplantation, with scalable, uniform, and affordable organoid production potentially reducing waiting times.

While promising, the study notes limits, including the absence of data on long-term viability beyond 48 hours and the need for further work to translate findings into clinical use.

The study, led by Garreta and colleagues, is positioned as a paradigm shift in regenerative medicine and could advance scalable solutions to organ shortages and organ engineering.

A broad, international collaboration underpins the work, with institutions such as IBEC, INIBIC, CIBER-BBN, ONT, UB, Navarra Health Research Institute, Málaga Biomedical Research Institute, UC facilities, ISCIII centers, and EBERS Medical Technology SL supplying perfusion technology.

The collaboration spans Europe and the United States, reflecting a multidisciplinary effort across universities and research centers.

Looking ahead, the research lays groundwork for broader organoid-based transplantation strategies, necessitating continued funding and exploration across different organ systems.

Ethical and broader implications include reducing dependence on human donors and the potential for patient-matched, personalized organoids, with applicability to other organs and future tissue-engineering approaches.

If translationally advanced, this approach could speed up organ preparation for transplantation, scale organoid production for drug screening and disease research, and help increase viable organ options.

The work outlines a preclinical pathway where organs slated for transplantation could be pretreated and evaluated under controlled, perfusion-based conditions before implantation.