Pioneering studies in organ transplantation emphasize innovations in normothermic regional perfusion and the molecular underpinnings of xenotransplantation. Recent findings reveal that genetically modified alpha-gal knockout pig kidneys exhibit delayed but notable immune activation in human recipients, indicating new targets for immunomodulation. Complementary research reports improvements in organ viability assessment technologies enhancing transplantation outcomes. These advances highlight the evolving landscape aiming to address organ shortages and rejection challenges.