Medicine · Transplantation · The Human Story
The quiet revolution in transplant medicine - and three lives that show what a second chance can build
Right now, more than 100,000 people in the United States are waiting for an organ transplant. Seventeen will die today while waiting. And yet, in the same moment, transplant medicine is undergoing a transformation so profound that within a decade, some of the diseases that currently destroy organs may be cured entirely - and the organs themselves may no longer need to come from another human being at all.
Organ transplantation is, by any measure, one of medicine's most extraordinary achievements. The ability to remove a failing kidney, heart, or liver from one body and restore it to function in another - and for the recipient to walk out of hospital and rebuild a life - remains astonishing regardless of how routine it has become in modern surgical centres.
But the supply has never matched the need. Every eleven minutes, someone is added to the waiting list in the US. A third of those waiting for a kidney will spend five or more years on dialysis before a match appears. Many will not survive the wait. The bottleneck is not surgical skill, nor the generosity of donors - it is biology. The immune system, ruthlessly efficient at identifying what does not belong, attacks transplanted organs as methodically as it attacks infections. The drugs required to suppress this response are blunt instruments: they lower the body's defences against everything, not just the transplant.
That is changing. Three forces are converging to transform what is possible: more precise anti-rejection therapies, the ability to grow new cells and organs from scratch, and - most dramatically - the first genuine cures for diseases that destroy organs in the first place.
In September 2017, Selena Gomez posted a photograph from her hospital bed. She was 25 years old, and she had just received a new kidney. The donor was her closest friend, actress Francia Raisa, who had offered her own organ without hesitation when Gomez's lupus - an autoimmune disease in which the body attacks its own tissues - had damaged her kidneys beyond recovery.
Lupus attacks the kidneys in roughly half of all patients, a complication called lupus nephritis. For Gomez, the disease had progressed to the point where transplantation was the only path that avoided a life on dialysis. Raisa, who had no obligation beyond friendship, underwent major surgery to donate one of her own kidneys. Both women recovered. The transplant took.
What Gomez did with the second chance is the more remarkable part of the story. Rather than withdraw from public life, she made the decision to stay visible and to use her platform deliberately. In 2020, she founded Rare Beauty - a cosmetics company built explicitly around mental health and self-acceptance - which reached a $2 billion valuation within three years and donated $100 million to mental health causes through its associated fund. She starred in three seasons of Only Murders in the Building, earning Emmy and Golden Globe nominations. She became, arguably, more herself after the surgery than before it.
She has been transparent about the mental health toll of chronic illness - the anxiety, the depression, the bipolar diagnosis that came alongside the lupus - and that transparency has made her one of the most influential advocates for the treatment of invisible illness in the world. None of it would have been possible without a friend, a surgeon, and the immunosuppressant drugs that have allowed her transplanted kidney to keep functioning for eight years and counting.
Not every transplant story belongs to a celebrity. Most of them belong to people like Abigail Beckman-Green - a swimmer from Michigan who received a kidney transplant at the University of Michigan Transplant Center in August 2016, and who was not, at the time, expected to set any world records.
Beckman-Green was young, determined, and uncomfortable with the narrative that a transplant meant curtailing physical ambition. She began training, carefully and seriously, and in 2023 competed in the World Transplant Games - an international athletic competition open exclusively to transplant recipients and living donors. She returned from the Games having won five gold medals and set five new world records in swimming.
The World Transplant Games, which began in 1978 and now attract thousands of competitors from dozens of countries, exist partly as celebration and partly as proof: that a body rebuilt by surgery can still run, jump, swim, and throw. They are one of the most quietly powerful arguments for organ donation that exists - a gathering of people who, by rights of medical probability, should not be here competing. Beckman-Green is one of them. So are the marathon runners, the cyclists, the 70-year-old weightlifters who turn up every two years to remind everyone watching what the gift of a second kidney can produce.
In 2025, she went to Cologne for the World Transplant Games and competed again. She had, by that point, been living with her transplanted kidney for nine years.
Not all transplants involve hearts or kidneys. One of the most scientifically significant developments in transplant medicine in 2024 and 2025 involves structures so small they require a microscope to see: the islets of Langerhans, clusters of insulin-producing cells scattered through the pancreas that, in people with type 1 diabetes, have been destroyed by the body's own immune system.
The concept of transplanting donor islets into a person with type 1 diabetes to restore insulin production - and cure the disease - has been explored since the early 2000s. The "Edmonton Protocol," published in the New England Journal of Medicine in 2000, showed it could work. The problem was the drugs required to prevent rejection. Standard immunosuppressants were too damaging to justify in otherwise-healthy young patients with a manageable condition. The cure was, in many cases, worse than the disease.
In 2024, a trial at the University of Chicago began testing tegoprubart - an investigational antibody developed by Eledon Pharmaceuticals - as the core of a new anti-rejection regimen for islet transplant recipients. Tegoprubart works differently from conventional immunosuppressants. Instead of globally suppressing the immune system, it blocks a single pathway: the CD40 ligand interaction that triggers the immune attack on transplanted cells. The immune system stays largely intact. Only the attack on the islets is stopped.
The results from the first six patients are extraordinary. All six achieved insulin independence after one or two islet transplants. The first three patients, transplanted over a year ago at the time of the most recent data release, remain completely insulin-free. One has maintained an HbA1c - the measure of average blood sugar - of 4.7% for over 15 months. A normal HbA1c in a non-diabetic person is below 5.7%. No serious infections. No rejection events. No thromboembolic complications.
For context: a person with type 1 diabetes, before this treatment, would typically take 4-8 insulin injections per day, monitor their blood glucose constantly, and face a lifelong risk of hypoglycaemic emergencies, kidney disease, blindness, and cardiovascular damage. After islet transplantation with tegoprubart, they are, by every clinical measure, no longer diabetic.
Tegoprubart is not the only route to this outcome. The FDA approved LANTIDRA in late 2023 - the first allogeneic (donor-derived) islet transplant product to receive regulatory approval in the United States. And further along the frontier, Vertex Pharmaceuticals' VX-880 - stem cell-derived islets grown in a laboratory rather than harvested from donors - has shown that 11 of 12 patients in its trial reduced or eliminated their insulin requirements, with all achieving HbA1c below 7.0%.
Beyond that, Sana Biotechnology has initiated first-in-human trials of hypoimmune gene-edited islets - cells engineered to be invisible to the immune system - which require no immunosuppression at all. If this works at scale, it would mean: donor-independent, immune-evasive insulin-producing cells that can be manufactured and transplanted into any patient, anywhere, with no ongoing medication required.
Type 1 diabetes has been, until now, a condition you managed for life. What islet transplantation is showing is that managed for life may be replaced, for many patients, with simply cured.
- Lisa Pedrosa
The transformation of transplant medicine is not limited to islets or kidneys. Three parallel developments are converging toward a future in which the waiting list - the great, lethal bottleneck of modern medicine - may become obsolete.
Xenotransplantation - the transplantation of genetically modified animal organs into humans - has moved from science fiction to clinical trial in the past two years. Surgeons at Massachusetts General Hospital performed the world's first transplant of a gene-edited pig kidney into a living human in March 2024. The organ functioned for months. In a separate case, a 69-gene-edited pig kidney functioned in a recipient for 271 days before being removed. The FDA approved the first formal clinical trials for pig-to-human kidney transplantation in 2025. The genetic editing - removing pig glycan antigens that trigger human immune rejection, inserting human transgenes to improve compatibility - is getting more sophisticated with every iteration.
3D bioprinting is still years from producing transplantable complex organs, but the pace of progress is accelerating. ARPA-H, the US government's advanced research agency for health, has launched the PRINT program - Personalised Regenerative Immunocompetent Nanotechnology Tissue - to develop 3D-printed, patient-specific organs that would require no immunosuppression because they would be grown from the patient's own cells. United Therapeutics has already 3D-printed a human lung scaffold containing 4,000 kilometres of capillaries and 200 million alveoli capable of oxygen exchange in animal models. The first transplant of a bioprinted kidney was targeted for mid-2025.
Precision anti-rejection medicine is replacing the blunt-instrument immunosuppression that has defined transplantation since the 1980s. Felzartamab, a newly developed antibody, specifically targets antibody-mediated rejection - responsible for approximately half of all transplanted kidney failures - without broadly suppressing immune function. CAR-T cell therapy is being adapted to induce transplant tolerance, with first-in-human trials beginning in 2025. Interleukin-6 blockade, already approved for other conditions, is showing promise in preventing rejection at the cellular level.
The through-line across all of these is the same: a movement from systemic suppression toward precision. The immune system is not the enemy - it is a precisely calibrated defence system that needs, in very specific circumstances, to be taught not to attack something that is genuinely safe. The science is learning, at last, to speak the immune system's own language.
Selena Gomez built a billion-dollar company that talks honestly about mental health to a generation that needed it. Abigail Beckman-Green stands on a pool podium with five gold medals and a kidney that is not her own. Somewhere in Chicago, six people who used to inject insulin multiple times a day no longer need to. Somewhere in a xenotransplantation lab, a gene-edited pig kidney is functioning in a human body, buying time while the waiting list shrinks and the bioprinters warm up.
These stories do not exist in isolation. They are connected by the same logic: that the difference between a life cut short and a life fully lived can come down to a cell, a drug, a surgical technique, or the decision of a stranger - or a best friend - to give something of themselves.
The science is not finished. But it is moving, and it is moving faster than it ever has before. Every islet transplant that holds. Every pig kidney that functions for another month. Every 3D-printed scaffold that passes an animal model. Every World Transplant Games swimmer who sets a new record. These are not separate events. They are the same story, told in the language of biology, about what a second chance, given carefully and received gratefully, looks like when you let it run.
© 2026 Lisa Pedrosa · lisapedrosa.com
All articles cited to primary institutional or peer-reviewed sources
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