First Lab-Grown Oesophagus Restores Swallowing in Pigs Without Immunosuppression, Paving the Way for Pediatric Trials Within Five Years
UCL and Great Ormond Street Hospital scientists built a functional oesophagus from a donor scaffold and the recipient's own cells, restoring normal eating in eight pigs within six months.
Overview
Scientists at University College London and Great Ormond Street Hospital (GOSH) have created the first laboratory-grown oesophagus that can safely replace a full section of the organ and restore normal swallowing in a growing animal, according to a study published in Nature Biotechnology on March 20, 2026. The engineered tissue integrated fully within three months, developed functional muscle, nerves, and blood vessels by the six-month mark, and required no immunosuppression — a critical advance that could transform treatment for children born with life-threatening oesophageal conditions.
What We Know
The team, led by Professor Paolo De Coppi and including lead author Dr. Natalie Durkin and co-lead Dr. Marco Pellegrini, developed a four-step process to build the replacement organ, according to UCL. First, a donor pig oesophagus was carefully stripped of all its original cells through a process called decellularisation, leaving only the underlying structural scaffold. The scaffold was then repopulated with muscle cells taken from a small biopsy of the recipient pig. After the cells were multiplied in the laboratory and injected into the scaffold, the graft was placed in a bioreactor where growth fluids were pumped through the tissue for one week. The entire process took approximately two months.
All eight pigs that received the transplant survived the critical first 30 days, according to UCL. By six months, the lab-grown grafts had developed functional muscle, nerves, and blood vessels that allowed the transplanted oesophagus to contract and move food normally. The animals ate without assistance and grew at healthy rates. Spatial transcriptomic analysis confirmed that gene expression patterns in the engineered tissue matched those of natural oesophageal tissue.
Some animals developed strictures — a narrowing of the oesophagus — but these were managed through routine endoscopic procedures, as reported by EurekAlert. Crucially, no immunosuppressive drugs were required because the graft contained the recipient’s own cells. “Our technology could allow us to build a child a new oesophagus, using their own cells, without the need for long-term immunosuppression,” Dr. Pellegrini said, according to UCL.
The primary target for the therapy is long-gap oesophageal atresia (LGOA), a condition in which babies are born with a section of their oesophagus missing. Approximately 180 babies are born with oesophageal atresia in the United Kingdom each year, with roughly 10 percent presenting the long-gap variant, according to UCL. Current treatment requires major surgery to reposition the stomach or intestine to bridge the gap, often causing lasting complications including breathing problems and gastrointestinal issues.
What We Don’t Know
While the results are promising, several questions remain before the therapy can be offered to human patients. Independent experts have raised concerns about whether the engineered tissue can truly grow with a developing child. Professor Dusko Ilic of King’s College London noted that normal weight gain in the pig models should not be interpreted as evidence of graft growth, and that the persistent strictures and need for repeated endoscopic interventions suggest the construct may function more as a remodelling scaffold than a dynamically growing tissue.
Long-term studies with direct measurements of graft expansion will be needed to demonstrate that the engineered oesophagus can accommodate somatic growth over years rather than months. The study also does not address how the approach would scale for human manufacturing or what regulatory pathway first-in-human trials would follow.
Analysis
The research represents a meaningful step forward in the long-running effort to engineer replacement organs from patients’ own cells. The oesophagus is particularly challenging because it must perform coordinated muscular contractions to move food, making it far more complex than simpler tissues like skin grafts or bladder patches that have been engineered previously.
Professor De Coppi expressed cautious optimism about the timeline. “With the success of this research, we hope that we can be successfully offering an engineered tissue alternative to children who desperately need it, within five years,” he said, according to EurekAlert.
The study was funded by Great Ormond Street Hospital Charity, the Oak Foundation, LifeArc, and the Francis Crick Institute.