Lung transplants can be lifesaving for patients with end-stage lung diseases such as cystic fibrosis, COPD, pulmonary fibrosis, sarcoidosis, and pulmonary hypertension. Wait times for a lung vary from days to years, depending on a complex set of circumstances. In the US, 1400 adults and children await lungs at any given time. Less than a third of them will get one.
Position on the wait list is based on several factors: medical urgency, compatibility with an available lung, distance from the donor hospital, and pediatric status, according to the United Network for Organ Sharing.
An easily tested indication of whether a person's body will accept a transplanted organ is the ABO blood type. It doesn't have to match between donor and recipient, but it must be compatible. The A and B antigens (cell surface molecules) are sugars that are attached to proteins and fats on a cell's surface. The blood type is a single-gene trait.
Canadian researchers have tested a way to strip donor lungs from type A individuals of the A antigens that make them type A, using enzymes. Denuding the lungs essentially creates an "ABO-agnostic organ" that could, theoretically for now, nestle into the chest of a person with any ABO blood type and not induce rejection. The idea has been around for awhile without much success, but using a new pair of enzymes, discovered in the human gut microbiome in 2019, seems to improve on past attempts.
"The treatment described here could further expand the pool of universal donor organs from the current 55% (blood group O donors) to over 80%. This strategy may greatly improve access and fairness of organ allocation," Aizhou Wang and colleagues from the University of Alberta write in Science Translational Medicine. The strategy could be applied to organs other than lungs. More than 100,000 individuals in the US await organs.
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