Is the era of "universal" organ transplants coming?

Recently, a new study in Science Translational Medicine brings us one step closer to a universal transplant organ, according to the results of the experiment, the researchers achieved the conversion of donor organ blood type in an extracorporeal lung perfusion device

When it comes to organ transplants, it's easier to think of many patients lining up for the right organ, but in reality, there are also donated organs that may have to be discarded because there are no blood-compatible recipients nearby

And people with type O blood often face a higher risk of death because they have to wait longer for blood type problems

If there was a way to remove blood group antigens from other blood group organs, those organs could become a universal transplant organ for all waiting patients

▲The extracorporeal perfusion system used in the study (Image source: Reference [2], credit: University Health Network)

The enzymes used in previous studies were all derived from the human gut bacteria, which feed on sugars similar to blood cell antigens.

The research team first obtained some lungs that lost their value for transplantation, and used an extracorporeal lung perfusion device to keep the organs alive, mainly to maintain normal body temperature in the lungs, and to obtain nutrients, protein and oxygen through the device pump

Preliminary tests of the study found that exposure of type A lungs to these enzymes continuously for 4 hours eliminated 97% of type A antigens in the lungs

▲After adding enzymes to the perfusion system, most of the A antigens can be eliminated (Image source: Reference [3])

In addition, the research team conducted a safety assessment of these modalities, which were tested in type A lungs, where the right side of the lung was treated with enzymes and the left side served as a control

The right lung still maintains intact vitality after being exposed to type O blood, while the left lung will soon experience hyperacute rejection, indicating that the anti-A antibodies in type O blood are causing extensive damage to organs

They are now preparing to test the real-world application and safety of such methods in clinical trials, and it is also necessary to demonstrate that the two enzymes used in the perfusion do not cause harm to the patient's body

References:

[1] Creating 'universal' transplant organs: New study moves us one step closer.

[3] Conversion of blood type A donor lungs into universal blood type lungs using ex vivo ABO enzymatic treatment, Science Translational Medicine (2022).

(Original abridged)