2025-10-03 カナダ・ブリティッシュコロンビア大学 (UBC)
The kidney, pre-transplant, in a perfusion device which is used to circulate a solution that contains the converting enzymes. Source: Nature Biomedical Engineering.
<関連情報>
- https://news.ubc.ca/2025/10/universal-organ-transplant/
- https://www.nature.com/articles/s41551-025-01513-6
酵素変換O型腎臓は、ヒトの死体モデルにおいて超急性拒絶反応を起こさずにABO不適合移植を可能にする Enzyme-converted O kidneys allow ABO-incompatible transplantation without hyperacute rejection in a human decedent model
Jun Zeng,Ming Ma,Ze Tao,Zhengsheng Rao,Chaomeng Wu,Saifu Yin,Xiaojuan Jiang,Guo Chen,Zhiling Wang,Dan Huang,Mengli Zhu,Ling Liu,Wenqian Huo,Hao Yang,Hui Guo,Gang Chen,Feng Li,Chengyu Zheng,Dajiu Huang,Peter Rahfeld,Jayachandran N. Kizhakkedathu,Stephen G. Withers,Xiaofeng Lu,Keqin Zhang,… Turun Song
Nature Biomedical Engineering Published:03 October 2025
DOI:https://doi.org/10.1038/s41551-025-01513-6
Abstract
ABO-incompatible kidney transplantation is widely used to meet the escalating need for organs. Current recipient-centric desensitization protocols involving antibody depletion through plasmapheresis increase the risk of infections, perioperative bleeding events and costs. Here we present a donor-centric desensitization protocol, converting type-A kidneys into enzyme-converted O kidneys during hypothermic perfusion to remove the A antigen from the kidneys. An ex vivo model resulted in no antibody-mediated injury. Encouraged by this, an enzyme-converted O kidney was transplanted into a type-O brain-dead recipient with a high titre of anti-A antibody, and no hyperacute rejection was observed. The graft was well tolerated with no evidence of antibody-mediated rejection for 2 days. Antibody-mediated lesions and complement deposition were found starting 3 days post-transplant, coinciding with A-antigen regeneration, and later higher Banff scores, suggesting an immune-mediated response. Single-cell sequencing confirms the elevated expression of accommodation-related genes, suggesting the potential for longer-term tolerance. This study provides a donor-centric organ engineering strategy and has the potential to broaden the reach of ABO-incompatible kidney transplantation, improving the fairness of and access to organ allocation.
