Alice Cai
Project: Using “Azymes” to increase access to safe ABO-incompatible heart transplantation for women and children
“Despite the incredible advances researchers have made in transplantation science over the past decades, there remains so much hidden complexity in the adaptive capabilities of the immune system, and so much progress to be made in how our health-care systems assess candidates for heart transplantation and distribute organs equitably. Something impressed upon me this summer is how reaching this potential is a product of constantly questioning why things are done a certain way, both on an experimental basis and a systematic one, and seeing opportunities to innovate upon the status quo. These innovations will save countless lives, and it’s incredibly exciting and fulfilling to be a part of the research community in this way.”
Summary: Women and children have historically had less access to heart transplantation, making up only 25 per cent and 14 per cent of recipients, respectively. Women are more likely to develop immune defenses against transplanted organs due to changes that occur in the body during pregnancy, which greatly limits how they can receive safe transplants. Children face a shortage of small donor hearts, which come from other children.
One way to reduce the shortage is to make more donor organs suitable for transplantation. Body tissues such as the heart contain blood-group markers for A, B, AB or O. Most heart transplants must be compatible with the recipient’s ABO blood type to prevent rejection. Women and children with blood types B and O face further disparity in access to safe heart transplantation due to a shortage of compatible donors.
My supervisor, Dr. Lori West, and her collaborators have developed a possible solution using special enzymes called Azymes to remove A-blood-group markers from type A tissue, effectively changing it to type O, considered the universal donor blood type. Previous studies have shown that type A human lungs and kidneys can be converted to type O by treating them with Azymes. This project will examine whether the same approach can convert type A hearts to type O. The hearts will be perfused, or circulated, with an Azyme solution. We will stain the heart tissue for specific blood group markers and analyze the results under a microscope to confirm success.
This project is an important step towards the clinical use of Azymes to create blood-group-O donor hearts. Successful application could greatly increase access to safe heart transplantation and help alleviate the transplant disparity for women and children, allowing them to live longer and healthier lives.
Alice Cai was supervised by Dr. Lori West in the Department of Pediatrics in the Faculty of Medicine & Dentistry. Her WCHRI summer studentship was jointly funded by the Stollery Children’s Hospital Foundation and the Alberta Women’s Health Foundation. She is studying pharmacology at the University of Alberta.
Read more about WCHRI’s training awards for students at all levels and generous grants for researchers. See the rest of the 2026 summer studentship recipients here.
