Blood type has long been one of the many criteria involved in matching a donor organ to a hopeful recipient. The guidelines for this, however, aren’t exactly straightforward; for example, people with type AB blood can receive donations from any type but can only donate to others with type AB, while those with type O blood can donate to anyone but can only receive donations from others with type O. (This is why you’ll often see your local blood drive begging for O-type donors.) This becomes a problem when someone in desperate need of a donor organ is forced to sit for months on a waitlist until an organ with a compatible blood type becomes available.
In new research published Wednesday, scientists from a handful of Canadian universities write that they’ve found a way to circumvent this issue by converting blood type A lungs to blood type O lungs during ex vivo lung perfusion, or EVLP (which is the process by which a donor lung is kept “alive” and possibly conditioned for transplant outside a human body). The team accomplished this by using enzymes FpGalNAc deacetylase and FpGalactosaminidase to remove the blood type A antigen from the donor organ. Then they exposed the organ to plasma from type O donors, simulating an environment in which the previously-type A lungs would be transplanted into individuals with type O blood.
Transplant surgeons performing ex vivo lung perfusion. (Photo: Penn Medicine)
Treatment during EVLP took only four hours and showed promising results with each of the eight involved donor lungs, which had previously been deemed unsuitable for transplantation. Following each simulation, the team detected “minimized antibody binding, complement deposition, and antibody-mediated injury,” which are typically observed after transplants in which the donor organ and patient are incompatible. Better yet, the health of the lungs themselves weren’t affected at all.
The process used to convert these lungs should be similarly applicable to any donated organ, according to study author Marcelo Cypel. But the team’s findings only mark the beginning of the journey necessary to safely provide human patients with converted organs. Cypel and his colleagues hope to begin clinical trials within the next year or so, which will allow them to determine the long-term effects of organs with modified blood types that are transplanted into human patients. If all goes well, this novel treatment could bump the number of organs that can be universally donated from 55 percent up to 80 percent.
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