Table of Content

Open Access Review

Risk Assessment in Clinical Histocompatibility Testing: Challenges, Strategies, and Future Directions

Received: 15 July 2025;  Published: 25 November 2025;  doi: 10.21926/obm.transplant.2504260

Abstract

Though the role of clinical histocompatibility testing is fundamental to successful transplant, systematic risk assessment and mitigation strategies remain underutilised in this domain. This review addresses risk identification, analysis, and control measures across the pre-analytical, analytical, and post-analytical phases of clinical histocompatibility testing, in line with international standards such as ISO 15189:2022. A structured, risk-based quality management system (QMS) is imperative for ensuring accurate [...]

116 594

Open Access Original Research

Immunologic Response after COVID-19 Vaccination in Heart Transplant Recipients

Received: 30 June 2025;  Published: 21 October 2025;  doi: 10.21926/obm.transplant.2504259

Abstract

To date, all large-scale randomized controlled trials for COVID-19 vaccines have excluded solid organ transplant recipients; therefore, the effectiveness and safety of COVID-19 vaccines in preventing coronavirus infection using COVID-19 vaccines in patients with heart transplants have not been sufficiently studied. This paper presents the characteristics of humoral and cellular immunity in heart transplant recipients following vaccination against coronavirus infection. The study group consisted of 40 patients who u [...]

268 1422

Open Access Review

Antibody-Mediated Rejection in Kidney Transplantation: Immunopathogenesis, Innate–Adaptive Crosstalk, and Therapeutic Advances

Received: 17 April 2025;  Published: 10 September 2025;  doi: 10.21926/obm.transplant.2503258

Abstract

Antibody-mediated rejection (ABMR) remains a major barrier to long-term graft survival in kidney transplantation. Defined by the presence of donor-specific antibodies (DSAs) and characteristic histological changes, such as C4d deposition in peritubular capillaries, ABMR can present acutely, chronically, or subclinically, often manifesting as graft dysfunction. Recent advances in genomic profiling and diagnostic assays have improved our understanding of its pathophysiology, yet therapeutic strategies remain limited. [...]

648 8211

Open Access Review

Precision Medicine in Liver and Lung Transplantation: Integrating Immunology, Regenerative Therapies, and Computational Advances

Received: 25 May 2025;  Published: 09 September 2025;  doi: 10.21926/obm.transplant.2503257

Abstract

Liver and lung transplantation remain among the most intricate and resource-intensive arenas in modern medicine, challenged by organ scarcity, immunological complexities, and the persistent threat of rejection. According to recent WHO and UNOS reports, approximately 100,000 patients globally await liver transplants annually, with only 30-40% receiving transplants, resulting in waitlist mortality rates of 15-20%. Similarly, lung transplant demand exceeds supply by a factor of 4:1, with 5-year survival rates remainin [...]

492 2821

Open Access Review

The Essentials of Cell-Mediated Immunity Assays for the Management of CMV Infection after Solid Organ Transplantation

Received: 12 March 2025;  Published: 04 September 2025;  doi: 10.21926/obm.transplant.2503256

Abstract

Provided that cell-mediated immunity (CMI) is known to be vital in managing CMV infection post-transplant along with improving methods to predict the development of cytomegalovirus (CMV) following transplant, CMV-specific-cell-mediated immunoassays have been developed, commercially and research based, to be used in conjunction with pre-transplant CMV serological testing and prophylaxis to help tailor an individual care plan post-transplant. In this review, we assess the status of CMV CMI assays, and their potential [...]

348 2442

Open Access Original Research

Duration of Hospitalization is Associated with the Gut Microbiome in Patients Undergoing Hematopoietic Stem Cell Transplantation: Early Results from a Randomized Trial of Home Versus Hospital Transplantation

Received: 24 April 2025;  Published: 25 August 2025;  doi: 10.21926/obm.transplant.2503255

Abstract

Home-based hematopoietic stem cell transplantation (HCT) is an innovative care model with growing interest, but its impact on the gut microbiome remains unexplored in a randomized setting. We present interim results from the first randomized controlled trials (RCT) evaluating the effect of HCT location—home versus hospital—on gut microbial diversity and antimicrobial resistance (AMR) gene carriage. We hypothesize that patients randomized to undergo home HCT would have higher gut taxonomic diversity and lower AMR ge [...]

986 3458

Open Access Short Report

Donor-Derived Cell-Free DNA Assessment in a Predominantly Hispanic/Latino Lung Transplant Population: Single-Center Analysis

Received: 31 March 2025;  Published: 21 July 2025;  doi: 10.21926/obm.transplant.2503254

Abstract

The demographics of lung transplant (LT) recipients show an evolution towards increased minority racial/ethnic representation, thanks to an increased focus on inclusion in LT access, healthcare and outcomes. Herein we assess potential differences in LT allograft health in a predominantly Hispanic/Latino (HL) vs Non-Latino/White (NLW) cohort during surveillance for acute rejection by analyzing the fraction of donor-derived cell-free DNA (dd-cfDNA%), a plasma biomarker of allograft injury. Of 245 LT recipients, media [...]

407 2443

Open Access Case Report

Checkpoint Inhibition Followed by CAR-T Cell Therapy in Refractory PMLBCL: Immunologic Response and Fertility Preservation in a Young Patient

Received: 22 February 2025;  Published: 18 June 2025;  doi: 10.21926/obm.transplant.2502253

Abstract

Primary mediastinal large B-cell lymphoma (PMLBCL) is an aggressive B-cell malignancy that may exhibit resistance to standard chemoimmunotherapy. Novel immunotherapeutic strategies, including checkpoint inhibitors and chimeric antigen receptor T-cell (CAR-T) therapy, are being explored in cases that are refractory to treatment. We report the case of a 29-year-old patient with refractory PMLBCL who was treated with pembrolizumab as a bridging therapy followed by axicabtagene ciloleucel (CAR-T) after failing R-CHOP a [...]

451 2724

Open Access Original Research

Modern UNOS Data Reveals Septuagenarians Have Inferior Heart Transplant Survival

Received: 10 November 2024;  Published: 11 June 2025;  doi: 10.21926/obm.transplant.2502252

Abstract

While heart transplantation is increasingly performed in the United States for elderly patients, survival outcomes have primarily been analyzed in single-center studies. The few existing long-term studies have indicated no difference in HTx outcomes between patients ≥70 years and 60-69 years age, but these studies only assessed to 5-years post-transplant and included data from the 1980-90s, introducing significant variance due to poorer outcomes in that era. We analyzed the UNOS database from 1987-2020, stratified [...]

518 3263

Open Access Review

Integrating RNA-Seq Biomarkers and Diagnostic Algorithms to Improve Liver Transplant Outcomes: A Comprehensive Review

Received: 21 February 2025;  Published: 09 June 2025;  doi: 10.21926/obm.transplant.2502251

Abstract

Graft rejection, early allograft dysfunction (EAD), and poor diagnostic accuracy are some of the challenges that still need to be addressed, even though liver transplantation (LT) has the potential to help patients with end-stage liver disease (ESLD) significantly. Traditional procedures, such as liver biopsies and liver function tests (LFTs), often fail to identify abnormalities early and with accuracy. Genomic RNA sequencing (RNA-Seq) has recently emerged as a powerful approach for identifying molecular markers o [...]

809 6031

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