NHS Blood and Transplant (NHSBT) is rolling out a programme to introduce ‘double-matched’ blood transfusions to 24 kidney transplant units across England, with the aim of reducing the number of people waiting years for kidney transplants and people facing kidney transplant rejection.
People with kidney disease often need multiple blood transfusions because their kidneys cannot make enough of a protein called erythropoietin, which stimulates red cell production. In a blood transfusion, the donor and recipients’ red blood cells are matched. Under the programme, white blood cells will be matched as well, reducing the risk of patients developing an immune system response to other people’s tissue types.
Becoming sensitised following a blood transfusion can cause problems for kidney patients. It is normal for transfusions to contain small numbers of white blood cells; on the surface of these cells are antigens called human leucocyte antigens (HLA). If the HLA of the donor and the transfusion recipient are different, the recipient can become sensitised and produce antibodies against the donor’s HLA.
If a person becomes sensitised to many HLA types, it can become very difficult to find a kidney they can receive safely. Currently, around a third of people who get blood transfusions become sensitised to tissue types, which means they have to wait much longer for a transplant.
HLA sensitisation can also cause problems after transplantation, when around 30% of patients will need a blood transfusion. In transplant recipients, the HLA antibodies may identify the transplanted kidney as ‘foreign’ and attack it, which can lead to transplant rejection.
Figures released by NHSBT in August 2026 reveal that 7,203 people are currently waiting for a kidney, including 138 children, more than all other organs combined; approximately 300 people die waiting for a kidney transplant each year.
The ‘double-matched’ blood transfusion programme for kidney patients could stop up to 100 transplants being rejected every year. There could be particular benefit for people with non-European heritage, who often receive blood transfusions from people with European heritage, with a higher likelihood of different tissue types, and for women who have become sensitised against their baby’s blood during pregnancy.
Blood transfusions save lives but for people on the transplant waiting list they carry a particular risk. By providing a new service to the wider NHS where we double match blood for white cells as well as red cells, we can reduce kidney rejection, and help stop so many people waiting many years for a match or even dying before they receive one. Innovation like this will help us meet out ambition of a world where everyone has the opportunity of getting transplant, where indicated. But we must also never forget no innovation would be possible without the incredible people who donate lifesaving blood and organs.Dr Colin Brown, NHS Blood and Transplant, Consultant Clinical Scientist and the Histocompatibility and Immunogenetics Scientific Lead
Some people wait far too long for a transplant, which can mean they become too poorly to receive one and then pass away. The waiting list is sadly at an all-time high, so where there are barriers like over-sensitisation, we very much welcome the science that could now make it possible to avoid an immune response which makes it more difficult to achieve or retain a successful kidney transplant. At Kidney Care UK we hear frequently from people who have been unable to get a match to receive the gift of a kidney and are left in limbo, hoping for a call that may never come. This news is reassuring to kidney patients, who frequently need blood transfusions, and women with kidney disease who want to have children. We remain continuously grateful for the selflessness of organ donors and their families.Fiona Loud, Policy Director at Kidney Care UK
Kidney patient and member of our Young Adult Kidney Group Ellyn Laws has had four transplants and is awaiting her fifth. She has also had several blood transfusions. She said:
My chances of getting a kidney within the next five years are extremely slim, and I have been told my dialysis access options potentially won't see me to transplant. I feel as though I'm fighting to just make it through the day to day. A kidney would give me a future I don't see myself having right now. I worry about my antibody sensitisation constantly. My levels of sensitisation are the difference between me getting a kidney and having a future and not. This new programme sounds like a positive step – I am completely behind it. Seeing how science has progressed since I was diagnosed in 1997 is remarkable. If it means more people are in with a chance of living their lives to the fullest, I am all for it.
This work follows a successful pilot in 2024. When the programme is established at all 24 kidney transplant units in England, NHSBT estimates it will provide 4,000 doubled-matched units of blood each year. While NHSBT is currently rolling out the £1.37m programme to English hospitals, it will also work with partner blood services in the other UK countries to provide blood.