While acknowledging risks of cross-species disease, Dr. Nicholas LaRusso envisions genetically modified pig livers wiping out human liver scarcity.

Question: What is the future of organ transplantation?

Nicholas LaRusso: One of the great things about the liver is that it regenerates. So, if you cut half of someone’s liver, it grows back. That’s why we can now not only use cadaver livers, but we can use portions of living donors. It’s entirely possible, and there’s work being done in this area, that in the future a liver transplant will be no more than an injection of a number of cells that will implant somewhere in the body and will grow and form an entire new liver. This is the whole area of stem cell transplantation

Then I think the last area, and this is a fairly controversial area, but I think has great potential, and the background here is, that as you maybe aware, there are many people particularly with liver disease, many more people that need livers than we currently have livers for.

There’s a whole area called xenotransplantation in which the idea is that we would take animals, pigs are currently the preferred animal, and be able to modify them genetically in such a way that a human would not only not reject a pig liver, but that any potential diseases that would be unique to animals would not be able to be contracted by a human. This is a big concern right now.

You can envision 20 years from now everyone who needs a liver having access to one because you walk in to a facility, you take out a pig and you use the pig liver for the patient.

Technical advances, leading to minimally increasingly, minimally evasive surgery, new drugs and ultimately sufficient understanding of the immune system that no drugs would be necessary, the use of cells rather than whole organs, and potentially the use of animal organs--are probably the four areas of the future when it comes to solid organ transplantation.

Recorded on: June 24, 2009.