Xenotransplantation using genetically modified pig hearts has achieved unprecedented survival times in human recipients, with recent cases demonstrating functional cardiac output for weeks rather than days. The breakthrough involves pigs engineered with multiple genetic modifications to eliminate species-specific incompatibilities and reduce immune rejection responses. This represents a fundamental shift in transplant medicine's approach to addressing the critical organ shortage crisis. The progress validates decades of research into cross-species organ compatibility and positions xenotransplantation as a potentially viable solution for the 100,000+ Americans currently awaiting organ transplants. However, significant challenges remain before clinical implementation, including long-term immune suppression protocols, potential zoonotic pathogen transmission, and ethical considerations around using animal organs. The technology requires extensive safety data across larger patient populations and longer follow-up periods. While promising, these advances represent early-stage progress in what remains an experimental field. The successful cases demonstrate proof-of-concept rather than clinical readiness, and widespread availability likely remains years away despite the remarkable technical achievements since 2022.