Research Team Converts a Type A Kidney Into a Type O- Kidney

A breakthrough by Cambridge researchers may dramatically change transplant compatibility.  A recent experiment changed a kidney’s blood type; changing a type A kidney into a type O- kidney.  The blood type O- is known as the “universal donor”; thereby, making the kidney theoretically available to any transplant patient.  This would have a huge impact on those patients waiting for transplant due to blood type compatibility, and could be a complete game changer for minority ethnic groups in particular. Transplant candidates from ethnic minorities can have an even more challenging experience than other candidates. 

“We Know that people from minority ethnic groups can wait much longer for a transplant, as they are less likely to be a blood type match with the organs available”; Aisling McMahon, the executive director of research at Charity Kidney Research UK: which funded the work, said. Director McMahon went on to say, “this research offers a glimmer of hope to over 1,000 people from minority ethnic groups who are waiting for a kidney”. 

Some ethnic minorities may have to wait twice or three times as long on a transplant list for an available donor kidney.  If the work done at Cambridge is proven to be safe and effective, minority transplant candidates could become eligible for kidneys much faster.

The Cambridge research team is led by professor of transplant, surgeon Mike Nicholson, who said, “One of the biggest restrictions to who a donated kidney can be transplanted to is the fact that you have to be blood group compatible”. 

The human body's’ response to a transplanted organ is to treat it as something that needs to be attacked. It is the same response that our body has to things such as bacteria, viruses, tumors, and parasites.  A transplanted organ from a non matching blood type exacerbates the difficulties that occur. 

Dr. Nicholson goes on to explain; “The reason for this is that you have antigens and markers on your cells that can be either A or B, your body naturally produces antibodies against the ones you don't have”.  

The work done by the research team at Cambridge focused on those antigens in order to change a type A kidney to a type O- kidney, which can be universally accepted. 

The team used a machine called a normothermic perfusion machine. Using deceased donor kidneys, the team flushed them with blood containing an enzyme that works like “molecular scissors”, cutting out the A or B antigen blood markers.  By stripping away these markers, the kidneys become type O in just a few hours.  

The team's findings to date are scheduled to be published in The British Journal of Surgery; Yet, their research is still ongoing. Using the same machine that they used to change the blood type of a kidney, the Cambridge researchers will now be testing how newly changed type O kidneys react to blood of different types. This will simulate what will happen in a transplant patient.  From there, the team will figure out how to test this technique with transplant patients.

A patient in the UK named Ayesha,  who is on a transplant waiting list, and a member of an ethnic minority group, says “the research will offer so much hope to minority groups still waiting for a transplant, and could help to save many lives”.  

The Cambridge research team is led by professor and surgeon Mike Nicholson, and PhD student Serena Mac Millan.

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Video

Rajamanickam Antonimuthu covers this topic in this video. The transcript of the video is below.

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Video Transcript

Researchers have been able to alter the blood type of deceased donor kidneys using “molecular scissors.” The discovery offers hope to ethnic minority patients who struggle to find suitable transplants.

Researchers at the University of Cambridge have successfully altered the blood type on three deceased donor kidneys in aground-breaking discovery that could have major implications for kidney patients.

The project, funded by charity Kidney Research UK, could increase the supply of kidneys available for transplant, particularly within ethnic minority groups who are less likely to be a match for the majority of donated kidneys.

Professor Mike Nicholson and PhD student Serena MacMillan used a normothermic perfusion machine – a device which connects with a human kidney to pass oxygenated blood through the organ to better preserve it for future use – to flush blood infused with an enzyme through the deceased kidney.

The enzyme acted like “molecular scissors” to remove the blood type markers that line the blood vessels of the kidney resulting in the organ being converted to the most common O type. A kidney from someone with an A blood type cannot be transplanted to someone with a B blood type, nor the other way around. But changing the blood type to the universal O will allow more transplants to take place as O can be used for people with any blood group.

The discovery could be particularly impactful for people from ethnic minority groups who often wait a year longer for a transplant than Caucasian patients.

People from minority communities are more likely to have B type blood and with current low donation rates from these populations, there are simply not enough kidneys to go around.

In 2020/21, just over 9% of total organ donations came from black and minority ethnic donors whilst black and minority ethnic patients make up 33% of the kidney transplant waiting list.

The Cambridge team now need to see how the newly changed O type kidney will react to a patient’s usual blood type in their normal blood supply.

The perfusion machine allows them to do this before testing in people, as they can take the kidneys which have been changed to the O type, use the machine to introduce different blood types and monitor how the kidney might react, simulating the process of transplant into the body.

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References

Freethink

University of Cambridge

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About the Author

Monica McCarthy has bachelors in Political Science and Criminal Justice from Central Washington University.  A majority of her career was spent as a political consultant.   She currently works at KidneyLuv as a staff writer.

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Patient Education Disclaimer

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