Universal Kidney Could End Blood-Type Barriers

Scientists from Canada and China have created the world’s first universal kidney, capable of being transplanted into any blood type, a major leap in transplant medicine.

Highlights:

Enzymes convert donor kidneys into a neutral “type O” form
Early human model showed strong kidney function post-transplant
Could drastically cut global transplant waiting lists

A team of Canadian and Chinese researchers has achieved a historic feat in organ transplantation — developing a universal kidney that can be transplanted into recipients of any blood type ().

Published in Nature Biomedical Engineering, this breakthrough could overcome one of the biggest challenges in transplant medicine: blood-type incompatibility, which often prevents life-saving procedures.

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The Science Behind the “Universal” Kidney

The procedure involves using specialized enzymes that act like molecular “scissors,” cutting away surface antigens — the sugar molecules that define blood types such as A or B.

By removing these markers, the kidney is effectively converted into a type O organ, which the body’s immune system does not reject.

Co-author Stephen Withers from the University of British Columbia likened it to “removing red paint from a car to expose the neutral primer underneath.” The treated organ thus becomes immunologically invisible, potentially suitable for any recipient.

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Testing the Universal Kidney in a Human Model

In a remarkable first, the modified kidney was transplanted into a brain-dead donor subject with family consent. The organ began functioning immediately, filtering blood and producing urine like a normal kidney.

By the third day, mild immune responses appeared as traces of type A antigens resurfaced, but overall, the reaction was far less severe than typical rejection.

Encouragingly, researchers noted early signs of immune tolerance, indicating that the body was beginning to accept the modified organ.

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Tackling the Global Kidney Shortage

This innovation could significantly ease the global organ shortage crisis, especially for patients with type O blood — the hardest to match but most in demand. In the U.S. alone, about 11 people die each day while waiting for a compatible kidney.

Because type O kidneys can be used universally, their scarcity worsens the waitlist imbalance. The universal kidney approach may drastically reduce waiting times and increase fairness in organ allocation, ensuring patients from all blood groups have an equal chance at survival.

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Enzymes That Erase Immunity Barriers

The technique builds upon earlier findings where gut bacterial enzymes could strip antigens from red blood cells.

Now, the same principle is applied to kidney tissues, targeting sugar molecules that trigger immune attack. This enzymatic process avoids complex chemical modification and preserves the kidney’s cellular integrity, making it safer and more reliable than genetic or synthetic alternatives.

Challenges Ahead and Future Directions

While the results are promising, researchers caution that residual antigens reappearing after three days show there’s room for improvement. Future work will focus on refining the duration and intensity of enzyme exposure, enhancing complete antigen removal, and possibly combining the method with gene editing or immunosuppressants. The next step is to test the procedure in living donors and recipients, paving the way for clinical trials.

Transforming the Future of Transplant Medicine

Experts hail this study as a watershed moment that merges basic biochemistry with life-saving clinical innovation. The ability to make kidneys universally compatible could eliminate the need for expensive desensitization therapies, reduce rejection rates, and reshape global transplant policy. If validated, this discovery could bring organ transplantation into a new era — one where blood type no longer decides who lives or dies.

Reference:

Enzyme-converted O kidneys allow ABO-incompatible transplantation without hyperacute rejection in a human decedent model - (https://www.nature.com/articles/s41551-025-01513-6)

Source-Medindia