Incompatible blood kidney transplant
UCLA's team includes leading experts in incompatible blood type kidney transplantation. We routinely manage blood type incompatibilities for patients of all ages.
What is incompatible blood kidney transplant?
Until recently, we could not perform a kidney transplant unless both the kidney recipient and the donor had compatible blood types. About one-third of donors and recipients were declined due to ABO blood type incompatibility.
Now, using an innovative desensitization technique, we can eliminate a recipient's reaction to an incompatible blood type. This process allows more people to receive and benefit from a living donor kidney transplant.
Understanding ABO blood type compatibility
All people have one of four blood types: O, A, B and AB. We are all compatible with our own blood type and possibly with others:
- AB patients can get a kidney of any blood type. They are the universal recipient.
- A patients can get a kidney from someone with an O or A blood type.
- B patients can get a kidney from someone with an O or B blood type.
- O patients can only get a kidney from someone with the O blood type.
When a patient's potential living donor has one blood type, and the patient has a different, incompatible blood type, that donor would typically be unsuitable for that patient.
Fortunately, depending on the situation, we can often turn an incompatible donor blood type into a successful transplant, using incompatible blood type transplant or other approaches, such as our Kidney Exchange Program.
What is the process of ABO incompatible transplantation?
To prevent immediate organ rejection following ABO incompatible transplantation, our team performs a simple blood test. This test tells us how much antibody the patient has to the donor kidney's blood type.
In most cases, the level of antibody is treatable. The patient undergoes a two-step process to remove the blood group antibodies:
- Desensitization: First, we remove existing blood group antibodies from your bloodstream using a process called plasmapheresis, which looks similar to dialysis. Generally, people have several sessions of treatment, depending on how much antibody you have.
- Immune modulation: Second, we use intravenous immunoglobulin (IVIG) - a blood product containing the antibodies of thousands of people - and other medications to turn off the cells in your body from making more blood group antibodies.
This process usually takes about two to three weeks. Then, when your antibodies are at an acceptable level, the transplant can be performed. Your transplant donor does not need to do anything different from any other living donor kidney transplant donor.
We continue to monitor your antibody levels after transplant. Beginning two weeks after the operation, your medications and treatment regimens are the same as for blood group compatible transplant patients.
Learn more about our patient education for all kidney transplants.