A groundbreaking study has revealed how enzymatic conversion can transform blood group B kidneys to the universal type O, paving the way for preventing hyperacute rejection during ABO-incompatible kidney transplants.
Matching blood types between organ donors and recipients is pivotal for successful kidney transplantation, as mismatches can precipitate severe and rapid rejection. This study presents remarkable findings on employing α-galactosidase enzyme from Bacteroides fragilis to enzymatically convert type B kidneys to type O during hypothermic machine perfusion.
After three hours of treatment with the enzyme, research indicated over 95% of blood group B antigens were effectively eliminated from the kidney’s endothelial cells. Subsequently, these treated kidneys demonstrated resilience against antibody-mediated damage during ex vivo simulations of ABO-incompatible kidney transplantation, showcasing their potential for future clinical applications.
Encouraged by these results, the researchers conducted a pre-clinical transplant where they utilized one of the converted type B kidneys for implantation in a type O recipient with high levels of anti-B antibodies. Remarkably, the transplanted kidney remained viable for 63 hours without triggering hyperacute rejection.
The allograft revealed no signs of harmful antibody interaction even after the re-expression of B antigens within 48 hours post-transplantation, reinforcing the efficacy of the enzymatic method. This innovative approach not only holds the promise for extending the reach of kidney transplantation practices but could also result in shorter waiting times for suitable donors, especially improving access for type O patients.
This study sheds light on the pressing need to address the widening gap between organ availability and the increasing demand for transplants, particularly for sensitized patients struggling to find compatible organs.
According to the consensus among the research team, the enzymatic conversion method can significantly aid the transplantation process, enhancing donor-recipient matches and hence potentially saving many lives. The details of these significant developments were published recently, underscoring future prospects of expanded organ transplantation capabilities.