Researchers alter blood type in kidneys, increasing organ availability in patients with kidney disease.
Last June, a worldwide epidemiological study on the situation of kidney transplants had been published. Data was collected from 155 countries. Photo: Shutterstock
The transplant Kidney replacement is one of the kidney function replacement treatments, whether it comes from a deceased donor or a related living donor. It is indicated in cases of patients suffering from terminal (irreversible) chronic renal failure.
Currently, it is not possible to perform a transplant of organs from a person with blood type A, to another with blood type B, nor vice versa, however, it would be possible to do it if this blood type is changed to the most common, O.
Precisely, in the United Kingdom, researchers from the University of Cambridge managed to alter the blood type in donor kidneys, opening the possibility of increasing the supply of these organs for transplantation, especially in minority blood groups that pose compatibility difficulties.
To perform this procedure, Professor Mike Nicholson and PhD student Serena MacMillan used a normothermic perfusion machine to circulate enzyme-infused blood through the deceased kidney.
This enzyme acted like a “molecular scissors” in removing blood type markers that line the blood vessels of the kidney, thus turning the organ into the more common type O; the process lasted a few hours when it was successfully performed on three donor kidneys.
“Our confidence was really boosted following applying the enzyme to a piece of human kidney tissue and quickly seeing that the antigens were removed. After this, we knew the process was feasible and we just had to scale up the project to apply the enzyme to full-size human kidneys,” MacMillan said.
People from minority ethnic groups often wait an extra year for a transplant than white patients, so the study might have a positive influence for them, according to the experts. People from minority communities are more likely to have type B blood, and with the low donation rates of these populations, there are not enough kidneys to go around.
In 2020 and 2021, just over 9% of all UK organ donations came from black and minority ethnic donors. But black and minority ethnic patients make up 33% of the waiting list for kidney transplants. Now, the researchers need to see how the newly switched type O kidney will react with a patient’s usual blood type in their normal blood supply.
The machine allows them to do this before testing people, as they can take kidneys that have been switched to type O, and put in different blood types to control how the organ might react.
Research leader Mike Nicholson commented: “One of the biggest restrictions on who can transplant a donated kidney is the fact that it has to be a blood type match. The reason is that you have antigens and markers on your cells that can be A or B. Your body naturally produces antibodies once morest the ones you don’t have. Blood group classification is also determined by ethnicity, and minority ethnic groups are more likely to have the rarer type B.”
On the other hand, Dr. Aisling McMahon, executive director of research at Kidney Research in the United Kingdom, assured that the preliminary results of the research can be “change the game”.
After testing the reintroduction of other blood types, the team will study how the method might be used in a clinical setting. The research, funded by the charity Kidney Research UK, will be published in the British Journal of Surgery in the coming months.
Last June, a worldwide epidemiological study had been published on the situation of the transplant of kidney. Data was collected from 155 countries.
In 74% of those countries the transplant of kidney was available, with an average incidence of 14 per million population. accessibility to transplant it varied a lot; even in high-income countries, it was disproportionately lower for ethnic minorities.
Universal health coverage of all treatment costs for transplant was available in 31% of countries, and 57% had a registry of transplant.
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