March 20, 2026

expert reaction to study engineering a lab-grown donor pig oesophagus and implanting it into recipient pigs, as published in Nature Biotechnology

Prof Dusko Ilic, Professor of Stem Cell Science, King’s College London, said:

“The study represents a significant advance in engineering functional replacements for complex hollow organs, moving the field beyond structural reconstruction toward functional integration.

“However, the suggestion that this approach offers a solution for children born without an esophagus is premature.  There is no evidence that the construct can accommodate somatic growth.  Although the graft shows remodeling and functional integration over 6 months, it is implanted at a fixed length, and no longitudinal assessment of elongation or scaling with growth is provided.  Normal weight gain should not be interpreted as graft growth.  Moreover, persistent fibrosis, stricture formation, and the need for repeated interventions indicate that the construct behaves as a remodeling scaffold rather than a dynamically growing tissue.  Demonstrating true growth would require long-term studies with direct measurements of graft expansion and evidence of a self-renewing progenitor niche supporting coordinated tissue development.  Until then, claims of suitability for growing pediatric patients remain unsubstantiated.”

* ‘Functional integration of an autologous engineered esophagus in a large-animal model’ by Natalie Durkin et al. was published in Nature Biotechnology at 10.00am UK time on Friday 20 March 2026.

DOI: 10.1038/s41587-026-03043-1

Declared interests

Prof Dusko Ilic: “I confirm that I have no conflicts of interest to declare.”