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Bacterial ‘scissors’ that will boost the hopes of patients who desperately need a transplant

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For those facing long waits for a donor kidney, there was welcome news yesterday with news of a “game-changing” breakthrough that could mean more organs become available.

British researchers have announced that they have, for the first time, successfully changed the blood types of three human kidney donors from the rarer B-types to O-types, the most common type in the UK.

If the technology is successfully transferred from the laboratory to clinical practice, it could help save thousands of lives.

The kidney is the most frequently transplanted organ. Currently, people wait an average of two to three years for this type of transplant, enduring regular dialysis and the prospect of getting progressively sicker while they wait.

For those facing long waits for a donor kidney, welcome news came yesterday with news of a game-changing breakthrough that could mean more organs become available.  A photo of the file is used above

For those facing long waits for a donor kidney, there was welcome news yesterday with news of a “game-changing” breakthrough that could mean more organs become available. A photo of the file is used above

Donated kidneys from people who have died must match recipients with the same blood type as the donor. According to NHS Blood and Transplant, patients with rarer blood types therefore inevitably wait much longer than patients with more common types.

Mike Nicholson, professor of transplant surgery at the University of Cambridge, who led the new research published in the British Journal of Surgery, described the need for kidneys to be “blood type compatible” as “one of the biggest limitations on who a donated kidney can be transplanted into.” “.

There are four blood types: A, B, AB and O.

People with type A, B or AB have antigens on their cells – proteins that stimulate the body to produce antibodies. Your body naturally produces antibodies against blood type antigens that you do not have. However, type O blood cells have no antigens, which means they can be used as a type of “universal donor” for all blood types.

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Blood types are vital in organ donation. If someone with type A received a kidney from someone with type B blood, for example, then antigens on the recipient’s cells would attack and damage the donated organ.

So, as well as making more organs available, the new technique could also improve the longevity of transplanted organs, as blood type-incompatible transplants are at risk of rejection and failure, says Dr Adnan Sharif, a consultant nephrologist at the Queen Elizabeth Hospital in Birmingham.

Donated kidneys from people who have died must match recipients with the same blood type as the donor.  Therefore, according to NHS Blood and Transplant, patients with rarer blood types inevitably wait much longer than patients with more common types.

Donated kidneys from people who have died must match recipients with the same blood type as the donor. Therefore, according to NHS Blood and Transplant, patients with rarer blood types inevitably wait much longer than patients with more common types.

The British team achieved their breakthrough by removing B antigens from the lining of blood vessels in a donor’s kidney using an enzyme from the bacterium Bacteroides fragilis, commonly found in the human gut, which acts as molecular ‘scissors’.

In the lab, they pumped blood containing the bacteria-derived enzyme through the kidneys using an artificial pump that mimicked the action of the heart, and took a series of blood vessel samples during and after treatment. They then looked at the samples under microscopes and compared them to samples from kidneys that had not been treated.

What they found was an almost complete loss of blood group antigens in the treated kidney tissue. “If translated into clinical practice, it could change the way transplant organs are allocated and ultimately make the whole process fairer,” said Dr. Aisling McMahon, executive director of research at Kidney Research UK, which funded the study.

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In particular, it could dramatically improve the availability of donated kidneys for ethnic minorities, who are more likely to have rarer type B blood.

“Your blood type is partly determined by your ethnicity,” explains Dr. Sharif. “People from ethnic minorities are also more likely to have diabetes and high blood pressure, which puts them at greater risk of developing kidney disease.

“The consequence of both of these things is that about 33 per cent of people waiting for a kidney are from ethnic minorities, which is a much higher proportion than they represent in the general population.”

Researchers now need to see how the newly altered Type O organs will react when implanted in humans. If successful, the technique could hopefully also be used to change the blood types of other organs used for transplants, including the heart, says Dr. Sharif.

Jeremy Crane, consultant transplant and vascular surgeon at Imperial College London, told Good Health: “This is an excellent area of ​​research. However, although this new technique can change the blood group, it does not affect the tissue type, which is equally important when considering which organs should be allocated to compatible patients on the waiting list.”

And the breakthrough will not solve the problem of chronic lack of kidneys for transplantation in the first place, he adds.

“In my opinion, the real revolution will be xenotransplantation – organs that come from genetically modified animals bred for this purpose. There have already been some human transplants using pig hearts and kidneys with promising results, and the potential supply could be endless.”

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