Abstract: Thanks to the application of gene modification technology, the development of new immunosuppressive and the shift towards using pigs as the main organ donors, xenotransplantation has embarked on a new round of "ice-breaking journey". Xenotransplantation demonstrates strong positive value in addressing the imbalance between organ supply and demand, extending the lives of patients with organ failure and enhancing human physical functions. However, xenotransplantation also raises a series of ethical risks, such as safety concerns over health damage and virus transmission, the hollowing out of the principle of informed consent, the impairment of individual identity and independence, and the distribution fairness of access and capability for trials. To address these issues, a mechanism combining prior general consent and specific consent during the process should be established, along with a dynamic and traceable consent procedure to safeguard patient autonomy. A "waterfall-style" regulatory system and a mechanism for aggregating cutting-edge technologies should be created to enhance the safety of xenotransplantation. Distribution and governance rules should be formulated according to different stages and goals of xenotransplantation exploration to improve fairness. A typological approach should be used to determine which groups of people can undergo xenotransplantation under current medical conditions to achieve the minimization of harm.