Scientists Grow a New Oesophagus From a Pig's Own Cells — And It Works
In a striking proof of concept for regenerative medicine, researchers have successfully implanted lab-grown oesophagi into pigs, allowing the animals to resume normal eating and swallowing. The work, published in Nature Biotechnology by a team at University College London, suggests a future where patients with damaged or malformed food pipes might receive replacements built from their own tissue.
The Clinical Challenge
The clinical motivation is urgent. Children born with long-gap oesophageal atresia — a condition where the oesophagus fails to connect properly to the stomach — currently face brutal interventions.
Surgeons may relocate the stomach up to the neck, suturing it directly to the throat, or transplant a section of colon to bridge the gap. Both procedures carry significant complications.
Paolo De Coppi, a paediatric surgeon at UCL who led the research, has spent years pursuing less invasive alternatives.
Building a Replacement From Scratch
The approach required constructing a functional replacement from scratch through several stages:
The team harvested small samples of muscle and connective tissue from each recipient pig and converted them into two types of stem cells capable of generating other cell varieties.
Separately, researchers removed the cells from oesophagi harvested from sixteen young donor pigs, leaving behind bare scaffolds of structural protein.
Each scaffold was then injected with the recipient's own stem cells and cultured for two months, during which the cells proliferated across the framework.
The Experiment
The surgeons removed 2.5-centimetre segments of natural oesophagus from eight minipigs — ten-kilogram animals chosen to approximate the size of children who might one day benefit from this procedure — and replaced them with the bioengineered grafts.
A biodegradable mesh tube surrounded each implant to support the development of new blood vessels.
Five of the eight pigs survived the full six-month observation period. In those animals, the engineered tissue developed functioning muscle, nerves, and blood vessels. The pigs could swallow normally.
The remaining three animals were euthanised early for welfare reasons. While scar tissue developed around the grafts — causing some initial swallowing difficulties — the researchers observed that this resolved progressively over time.
Expert Perspective
Andrew Barbour, an academic surgeon at the University of Queensland, noted that the capacity to generate a structurally and functionally coherent oesophagus represents a meaningful advance in the field.
The spontaneous reduction in scarring observed during the study was cited as particularly encouraging for the potential clinical translation of this work.
From Pigs to Patients
The work builds on earlier experiments in mice and rabbits, but pigs represent a considerably more demanding model given their size and physiological similarity to humans.
The next step — moving from porcine subjects to human patients — will require navigating substantial regulatory and technical hurdles.
Still, for a population of children facing radical reconstructive surgery, the possibility of growing a replacement oesophagus from their own cells offers a vision of medicine that is, in the most literal sense, regenerative.
Based on: Bioengineered oesophageal scaffolds in large animal models; De Coppi P et al.; Nature Biotechnology, 2024.