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The making of the universal donor: a landmark in transplantation
Book chapter

The making of the universal donor: a landmark in transplantation

Dai Dao Nghiem
Cutting Edge Advances in Transplantation, pp 297-311
01 Jan 2026

Abstract

Background: The American Red Cross provided only 40% of the annual need of blood in 2022. Similarly, according to 2023 United Network for Organ Sharing data, 5.1 patients on the waiting list were competing for one kidney. Methods: To solve this severe shortage of blood and organs, efforts have been developed to remove all surface antigens of all cell surfaces (blood groups A, B, AB, and endothelial cells) using the naturally occurring or recombinant enzymes isolated from the gut microbiome, and to convert them to the universal O blood and organ donors. The development of these landmark findings will be reviewed and discussed. Conclusions: (1) Blood group A has been converted successfully to universal blood group O and used clinically. (2) Group A lungs have been converted to universal O-type lungs using the extracorporeal lung perfusion system. (3) Blood group A kidneys have been changed to O blood group after normothermic and hypothermic preservation.

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