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If you need an organ transplant, you may think the process involves simply waiting for donated organs to become available. But several factors affect whether a specific donated organ is right for you. Blood type in transplant is one of the most important considerations.

Many organs come from deceased donors, while others come from living donors. Doctors check certain criteria for you and the organ donor to see if the organ is a good match.

Does Blood Type Matter for Transplants?

Doctors consider your blood type — and the donor’s blood type — when deciding who should receive a donated organ. Certain proteins in the blood, known as antigens, must match up between the organ donor and recipient. If your blood type is incompatible with the donor’s blood type, your body may reject the donated organ.

What is blood type?

Blood type is a way health care providers identify certain substances in your red blood cells. They take a blood sample and examine it under a microscope. Your provider checks to see how antigens in your blood react to proteins produced by your immune system (antibodies).

This reaction tells your provider which specific antigens are on your red blood cells and what blood type you have. Possible blood types include:

• Type A
• Type B
• Type AB
• Type O

What blood type is a match for a transplant?

Matching blood types for transplant is about ensuring the organ donor’s blood type is compatible with the recipient’s. If you and your donor have blood antigens that don’t match, your immune system sees the donor’s antigens as a threat. Your body may attack these antigens to protect you, which can cause your body to reject your new organ.

Doctors make sure your blood type matches the organ donor’s blood type to give your transplant the best possible chance of success.

Matching Blood Types for Organ Transplants

When a donated organ becomes available, your transplant team checks your blood type and the donor’s blood type. The guidelines for organ donors are:

• Blood type A can donate to people who have type A or AB blood.
• Blood type B can donate to people who have type B or AB blood.
• Blood type AB can donate only to people who have type AB blood.
• Blood type O can donate to people with type A, B, AB, or O. People with type O blood are “universal donors.”

But guidelines are different if you’re receiving an organ. If you have:

• Blood type A: You can receive an organ from a donor with blood type A or O.
• Blood type B: You can receive an organ from a donor with blood type B or O.

If you have type AB blood, you’re a “universal recipient” and can receive an organ from donors with any blood type.

What is the hardest blood type for a kidney transplant?

People with type O blood can donate organs to anyone. But they can receive organs only from other people with type O blood. This is true for kidney transplants and other types of organ transplants, such as liver transplants.

Can blood type O get a kidney transplant?

If you have blood type O, you can get a kidney transplant. But finding a suitable donor may take longer. According to the National Kidney Registry, more than half of people on the waitlist for a deceased donor kidney have blood type O.

What Happens Next When Blood Types for Transplants Match?

If your blood type and your donor or recipient’s blood type match, you’ll both take more tests. Doctors take blood samples from each of you to perform:

• Antibody screen. Specialists check to see if the organ recipient’s immune system produces antibodies to protect the body from antigens in the donor’s blood. Antibodies against the donor’s blood could cause the recipient to reject the donated organ.
• Crossmatching. Doctors take blood samples from an organ donor and organ recipient to see how the samples react to one another. Crossmatching tells doctors how the recipient’s body will react to the donated organ.
• Tissue typing (histocompatibility) tests. Doctors examine white blood cells for proteins called human leukocyte antigens (HLAs). Tissue typing makes sure these proteins are a good match between you and your donor (or recipient) to help prevent organ rejection.

What to Know if You and a Living Donor Aren’t a Good Match

Living donor organ transplant helps many people with kidney failure and liver failure get new organs sooner. If a potential donor meets compatibility requirements, you may not have to wait for an organ from a deceased donor.

Not every living donor and organ recipient is a good match. But if your blood types aren’t compatible, you have other options, such as:

Paired organ donation

A paired organ donation helps ensure people who need a new organ can get one as soon as possible. They also help make sure potential donors can still give an organ, even if they aren’t a match with their intended recipient. Doctors match incompatible donors and recipients with other donors and recipients who are compatible with them for paired exchanges.

Antibody lowering treatment

If you have high levels of antibodies against a donor, your donor may still donate directly to you. Doctors may use certain treatments to help lower levels of incompatible antibodies in your blood, including:

• Intravenous immunoglobulin (IVIG). Doctors take antibodies (immunoglobulins) from healthy donors of a part of the blood called plasma. They use a needle and flexible tube (IV) to add healthy antibodies to your blood.
• Plasmapheresis. Specialists use a machine to separate plasma from your blood and remove extra antibodies.

Next Steps in Transplantation

When doctors confirm you and your donor are a good blood type match for organ donation, you’re on your way to a transplant. Your transplant team will contact you about any remaining tests and next steps. Talk to your transplant coordinator about any questions you may have.