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WorldKidney transplant : Changing kidney blood type may boost transplants

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Kidney transplant : Changing kidney blood type may boost transplants

In a breakthrough that could enhance the supply of organs for transplant, researchers have effectively changed the blood type of the donor’s kidneys.

The discovery has special implications for underrepresented populations, for whom it is frequently more difficult to find a match.

A blood type A person cannot donate their kidney to a type B person, and vice versa.

However, making a kidney’s blood type the universal type O will enable it to be transplanted into any recipient.

People from black and other ethnic minority groups often have to wait a year longer for a transplant than white patients because they are more likely to have the rarer B-type blood group.

Rates of organ donation among those populations are also lower. In 2020/21, just over 9% of total organ donations came from black and other minority ethnic donors, while people from those communities make up 33% of the kidney transplant waiting list.

Scientists at the University of Cambridge were able to use a normothermic perfusion machine – a device used to pass oxygenated blood through a kidney to help preserve it – to flush blood infused with an enzyme through a donor’s kidney.

The enzyme removes the blood-type markers that line the blood vessels of the organ, effectively changing its blood type to type O. The process took a matter of hours when it was successfully performed on three donor kidneys.

Serena MacMillan, a Ph.D. student who worked on the study, said it was “very exciting to think about how this could potentially impact so many lives”.

The next step is to see how the kidneys react when given a normal supply of blood from their new blood group, something which can again be tested using a machine before the kidney is transplanted into a patient.

The research, which is funded by the charity Kidney Research UK, is due to be published in the British Journal of Surgery in the coming months.

Dr. Aisling McMahon, executive director of research at the charity, called the work “potentially game-changing”.

This is a fascinating and compelling idea, but its impact on organ transplantation is still unproven.

There are questions about the science and how much more it can increase the availability of organs for donation.

It will take further tests to see how these tweaked organs perform when actually dealing with formerly mismatched blood. And to ensure their process does not damage the kidneys in any way.

This will have to be tested in the laboratory and then in small numbers of patients.

Also, the blood group is only one of three ways kidneys are matched before transplant and half the population is already either O positive or O negative (whose kidneys can be donated to anybody).

Tissue matching and cross-matching (in which the blood of donor and recipient are mixed to see if there’s a reaction) will still be a factor, particularly in ethnic groups.

For now, the best way of increasing the number of life-saving transplants remains more of us – from every community – becoming.
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