Can we prevent the development of harmful antibodies during blood transfusion?

25 March 2025

Dr Katrina Spensley from Imperial College London has received a training fellowship grant of £290,000 to look at how we can improve blood transfusion methods to minimise antibody production as this can reduce the likelihood of a transplant match and increase risk of donated kidney rejection.

The problem

Antibodies are proteins made by the immune system to protect the body from potentially harmful invaders. Human leucocyte antigens (HLA) are proteins found on the surface of cells which help the immune system to detect foreign (non-self) cells. If cells with HLA proteins belonging to someone else are identified by the immune system, it produces antibodies against them. These antibodies can be a problem for patients who require a kidney transplant because they reduce the number of donor kidneys that would be a suitable match and can also increase the risk of rejection.

Healthcare teams work very hard to find the closest possible match for donor kidneys, but the same does not happen routinely for blood transfusions. Studies suggest this can lead to the development of HLA antibodies after blood transfusions. This project is investigating whether matching blood transfusions would prevent these antibodies forming in individuals who have or who require a transplant.

Image of a forearm with canula inserted to draw blood

Blood draw

The solution

Katrina will initially compare the blood of patients who have had a blood transfusion, before or after transplantation, to understand the differences between those who develop antibodies and those who do not.

Based on initial findings, a computer programme will then be developed to select the best unit of blood for an individual - this will be tested using a series of anonymised blood donors and fictional recipients. She will then look at the impact of this programme in terms of value for money and benefits to patients.

What could this mean for kidney patients?

By reducing the number of individuals who develop potentially harmful antibodies, this work could help ensure that anyone likely to need a kidney transplant does not have their chances of a good match and long-term health of a donor kidney reduced following blood transfusion.

“We need to understand more about how the immune system responds to blood transfusions. This project aims to improve access to kidney transplants and success rates by reducing the development of antibodies in patients who need a transfusion to improve the quality of life for patients with kidney disease.” Dr Katrina Spensley.

Meet the researcher

“I am a clinical academic at Imperial College London with a mathematical background and an interest in data-driven science. The idea for this research came when I listened to a talk from somebody who had been looking at the impact on transplant survival of giving blood transfusions following transplant surgery. I contacted their supervisor, and we developed this project to look at individuals who have already had a blood transfusion either before or after a transplant and explore the differences in antibody production.

Through collaboration with NHS Blood and Transplant (NHSBT) we have used blood donor typing to show that most individuals receive a unit mismatched across most HLA antigens.

We will now take this work further and hope that it can make important advances in our understanding within transplant medicine and improve outcomes for kidney transplant patients.”