Blood Group Transplant
Blood Group Transplant: What You Need to Know About Compatibility
A blood group transplant refers to organ or stem cell transplants between individuals with different blood types. Matching blood types helps prevent immune rejection and increases the likelihood of success. This article explores compatibility, challenges, and solutions in ABO-incompatible kidney and stem cell transplants.

1. Blood Group Compatibility in Organ Transplants
Blood group matching is essential for transplants. The four major types—A, B, AB, and O—are defined by antigens on red blood cells:
- Type A: Has A antigens
- Type B: Has B antigens
- Type AB: Universal plasma donor
- Type O: Universal red blood cell donor
Rh factor (+ or -) adds an additional layer in determining compatibility.
2. Compatibility in Kidney, Liver, and Heart Transplants
- Kidney: Best outcomes with ABO and HLA matches. O-negative is ideal for universal donation.
- Liver: More flexibility; special protocols may enable mismatched donations.
- Heart: High rejection risk with mismatches—blood group matching is crucial.
3. Bone Marrow and Stem Cell Transplants
These require both blood and tissue (HLA) matching. Interestingly, a recipient’s blood type may change post-transplant to match the donor’s. Mismatches can be tolerated in select cases, especially in pediatric patients.
4. ABO-Incompatible Organ Transplants
Historically considered risky, ABO-incompatible transplants are now possible with:
Plasmapheresis
Removes antibodies from the recipient’s blood to reduce the chance of rejection.
Immunosuppressive Therapy
Medications suppress the immune response, allowing successful transplants even with blood group mismatches.
5. Challenges of ABO-Incompatible Transplants
- Immune Reaction: Antibodies may attack the donor organ.
- Higher Rejection Risk: Even with treatment, ABO-incompatible cases face elevated rejection risks.
6. Emerging Solutions
- Enzyme Therapy: Enzymes may help remove harmful antibodies.
- Desensitization Protocols: Use medications to suppress the immune system pre-transplant.
7. Blood Type Change After Stem Cell Transplants
Following successful engraftment, a recipient’s blood type may change to the donor’s as new cells are generated from transplanted stem cells.
Conclusion: Talk to a Nephrologist Today
Blood group compatibility plays a central role in transplant success. While ABO-incompatible transplants are becoming more feasible, matched donors still offer the best outcomes.
Schedule a consultation with Dr. Mukherjee to explore compatibility testing and personalized transplant planning.
Prof (Dr) D Mukherjee is an alumnus of the prestigious Armed Forces Medical College, Pune where he did his MBBS & MD (Medicine). Subsequently he went on to do his DM (Nephrology) from PGIMER Chandigarh, which is the foremost training institution for nephrology in India.