The 2026 ISHLT Consensus Statement on Clinical Cardiac Xenotransplantation

Published 20 February 2026

Mandeep Mehra, MD, MSc; Muhammad Mohiuddin, MD, DSc; Bruno Reichart, MD, PhD; Jan-Michael Abicht, MD; Jacinthe Boulet, MDCM, MPH; David Cooper, MD, PhD; Peter Cowan, PhD; Maria Crespo-Leiro, MD, PhD; Joachim Denner, PhD; Jay Fishman, MD; Bartley Griffith, MD; Wayne Hawthorne, MD, PhD; Emer Joyce, MD, PhD; Igor Konstantinov, MD, PhD; Anuradha Lala, MD; Matthias Langin, MD; Robert Padera, Jr., MD, PhD; Richard Pierson III, MD; Angelika Schnieke, PhD; Linda Scobie, PhD; Patricia Uber, PharmD; Eckhard Wolf, DVM; Ann Woolley, MD, MPH

J Heart Lung Transplant. February 2026.

• Advanced Heart Failure & Transplantation
• Cardiology
• Cardiothoracic Surgery
• Consensus Document
• Publications & Journals
• Research & Immunology
• Standards & Guidelines

The global shortage of donor hearts remains one of the most stubborn barriers in advanced heart failure care. Two decades after ISHLT first addressed xenotransplantation, this consensus statement provide a disciplined, evidence-based roadmap for what comes next.

Developed by a multidisciplinary panel of global experts as an update to 2000 ISHLT statement on xenotransplantation, this document reflects more than two decades of scientific progress, including the first two pig-to-human heart transplant experiences, and provides a structured framework addressing:

• Minimum preclinical evidence required before human trials
• Criteria for selecting appropriate adult and pediatric candidates
• Required genetic modifications of donor pigs
• Standards for surgical technique, perioperative care, and immunosuppression
• Expectations for immune monitoring, pathology, and infection surveillance
• Regulatory oversight and international coordination

This consensus statement is intended as a living blueprint, to guide clinicians, investigators, regulators, and industry partners as cardiac xenotransplantation enters its next, more disciplined phase.

Read at JHLT

Read the Perspective Piece at JHLT Download the Perspective Piece

The ISHLT Perspective Piece is a new document type developed to accompany all ISHLT Documents and is specifically designed for print publication in JHLT. The piece The piece will set the context for the document in an easy-to-read manner and serves as an opportunity for writing groups to speak directly to the heart and lung transplant community about the rationale behind each document, its most important takeaways, and the hard work that went into creating it.

---