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