An interventional study of Blood group A2 donor to blood group O recipient lung transplant surgery in Lung Transplant and ABO Incompatibility, sponsored by University Health Network, Toronto. Recruiting at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-29.
Sponsored by University Health Network, Toronto · Not applicable, Interventional, and Treatment
Blood group A2 to blood group O kidney and liver transplants have been shown to be safe and successful, especially in recipients with low pre-operative anti-A antibody titers and with the use of peri-operative antibody-depleting therapies. Since blood group O lung transplant candidates tend to have longer wait times and a higher waitlist mortality compared to other blood groups, we propose to conduct a prospective study of lung transplantation from blood group A2 donors to eligible blood group O recipients in an effort to increase the available donor pool. The aim of this study is to determine both the feasibility and safety of this specific type of ABO-incompatible lung transplant, and the impact of this practice on reducing transplant wait times among blood group O lung transplant candidates. This would represent the first prospective study of ABO-incompatible lung transplants worldwide.
Exclusion Criteria:
Procedure: Blood group A2 donor to blood group O recipient lung transplant surgery
Suitable blood group A2 donor lung transplant to a consented blood group O recipient who has acceptably low levels of anti-A antibody titres and a negative virtual cross-match at time of transplant
Post-transplant anti-A antibody titers
Time frame: post-op day 5 or day 12
Primary graft dysfunction grade
Time frame: post-op day 0, 1, 2, 3
Incidence of hyperacute antibody-mediated rejection
Time frame: post-op day 1, 2
C4d positivity on transbronchial biopsy samples
Time frame: 1 year
Incidence and severity of acute cellular rejection
Time frame: 1 year
Bleeding
Time frame: post-op day 1-7
Infection
Time frame: 10 years
Graft function
Time frame: 10 years
Incidence of malignancy
Time frame: 10 years
Chronic lung allograft dysfunction
Time frame: 10 years
Time to death or re-transplantation
Time frame: 10 years
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University Health Network, Toronto