Researchers have made a ground-breaking discovery that might dramatically increase the likelihood that patients in need of transplants will find a match by effectively modifying the blood type of three donor kidneys.
According to researchers, the invention may expand the number of kidneys available for transplant, especially among minority ethnic groups where finding a match is more difficult. A ‘blood type A’ person cannot receive a kidney transplant from a blood type B person, and vice versa. However, switching to the universal blood type O—which may be used for persons of any blood type—would enable more transplants to occur.
Researchers from the University of Cambridge flushed blood laced with an enzyme through the kidney of a deceased donor using a normothermic perfusion pump, a device that connects with a human kidney to flow oxygenated blood through the organ to better maintain it for future use. The kidney’s blood arteries were lined with blood type markers that were eliminated by the enzyme, which caused the kidney to change to the most prevalent O type.
Our confidence was increased once we put the enzyme on a slice of human kidney tissue and noticed very soon that the antigens were eliminated, said Serena MacMillan, a Ph.D. student at the University of Cambridge. After that, we were certain that the method was workable; we only needed to scale up the project to use the enzyme on full-size human kidneys. Using our normothermic perfusion machine to pump the enzyme through B-type human kidneys, we were able to transform the organ into an O-type kidney in just a few hours. The idea that something may potentially affect so many lives is incredibly thrilling.
The study may have special ramifications for minority ethnic groups because they frequently had to wait a year longer for transplants than white patients, according to experts. There aren’t enough kidneys to go around since people from minority communities are more likely to have type B blood and these populations have low donation rates. Just over 9% of all organ donations in the UK in 2020–21 came from people of color, even though 33% of kidney transplant waiting list patients are people of color.
The next step for the researchers is to observe how the patient’s normal blood type will affect the newly modified O-type kidney in their normal blood supply. They can use the system to take kidneys that have been altered to the O type and introduce various blood types to observe how the kidney may behave before doing tests on humans. Prof. Mike Nicholson, a professor of transplant surgery at the University of Cambridge, said that you have to be blood group compatible, which is one of the main limits on who can receive a donated kidney. You have antigens and markers on your cells that can either be A or B, which is the cause of this.
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When you don’t have certain antibodies, your body naturally makes them. Blood group classification is also influenced by ethnicity, with ethnic minorities having a higher prevalence of the B type, which is more uncommon. The executive director of research at Kidney Research UK, Dr. Aisling McMahon, stated that the research Mike and Serena are conducting could change the game. The researchers will investigate how the method might be applied in a clinical environment after testing the reintroduction of different blood types. The study, which was supported by the nonprofit Kidney Research UK, will soon be published in the British Journal of Surgery.
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