ABO incompatible kidney transplant

In an ABO incompatible kidney transplant, your donor's blood type and your blood type aren't compatible. For those who need it, Mayo Clinic doctors and surgeons have experience treating people with an ABO incompatible kidney transplant.

However, recent advances in paired donation have largely made the practice unnecessary for most people.

In the past, if your blood contained antibodies that reacted to your donor's blood type, the antibody reaction would immediately cause you to reject your transplant. This would prevent a successful transplant. Back then, the only option was to identify recipient-donor transplant pairs with compatible ABO blood types.

Over the years, advances in medicine made ABO incompatible kidney transplant possible between some recipients and living donors. The option of having a living donor with a different blood type reduced the time on a waiting list for some people.

With an ABO incompatible kidney transplant, you receive medical treatment before and after your kidney transplant to lower antibody levels in your blood and reduce the risk of antibodies rejecting the donor kidney. This treatment includes:

  • Removing antibodies from your blood (plasmapheresis)
  • Injecting antibodies into your body that protect you from infections (intravenous immunoglobulin)
  • Providing other medications that protect your new kidney from antibodies)

Mayo Clinic researchers were among the first to develop treatments to counteract antibodies to prevent rejection of a donor kidney with an incompatible blood type.

Researchers have also developed treatments to reduce rejection of a donor kidney when a recipient's antibodies react against a donor's tissue and cells (positive crossmatch kidney transplant).

Researchers continue to study the effect of antibodies after transplant and potential treatments to lower antibody levels. The goal of research is to prevent rejection of a donor kidney.

March 28, 2024