by Chawannuch Ruaengsri  , Miguel Alvarez-Cortes  , Marc Leon  , Manuel Quiroz-Flores  , Masafumi Shibata  and Yasuhiro Shudo

Received: 30 June 2025;  Published: 30 December 2025;  doi: 10.21926/obm.transplant.2504261

Donation after circulatory death (DCD) offers a vital strategy to expand the donor lung pool; however, DCD lungs are uniquely susceptible to warm ischemic injury during procurement. This chapter reviews evidence-based and emerging donor management strategies aimed at mitigating ischemic damage and optimizing the suitability of DCD lungs for transplantation, encompassing hemodynamic and ventilatory optimization, bronchoscopic clearance, targeted pharmacological interventions, and strategies to minimize transfusion r [...]

by Vikash Chandra Mishra  , Dinesh Chandra  and Vimarsh Raina

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

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 [...]

by Marina Zafranskaya  , Olesya Shatova  , Elizaveta Nazaranka  , Alena Кurlianskaya  , Galina Ivanchik  , Irina Russkih  , Alesia Vialichka  , Marina Kolyadko  , Tatyana Denisevich  , Svetlana Kulinich  and Darya Nizheharodava

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

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 [...]

by Livia Maria Surdi  , Maribel Dagher  , Tamara Merhej  , John Choi  and Jamil R. Azzi

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

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. [...]

by Tamer A. Addissouky

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

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 [...]

by Alexis Guenette  and Valentina Stosor

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

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 [...]

by Tessa M. Andermann  , Ke Zeng  , Sayal Guirales-Medrano  , Adam Groth  , Bhanu C. Ramachandran  , Shan Sun  , Alicia A. Sorgen  , Lauren Hill  , Amy T. Bush  , Hongwei Liu  , Corbin Jones  , Jeffrey Roach  , Brian P. Conlon  , Gauri Rao  , Nelson J. Chao  , Anthony A. Fodor  and Anthony D. Sung

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

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 [...]

by Lara Jones  , David Ross  , Andrew Doud  , Navchetan Kaur  , Sangeeta Bhorade  and Holly Keyt

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

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 [...]

by Filomena Emanuela Laddaga  , Tommasina Perrone  , Pellegrino Musto  , Ilaria Farella  , Stefano Martinotti  and Francesco Gaudio

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

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 [...]

by Manish Suryapalam  , Jay Kanaparthi  , Shineui Kim  , Pedram Shafiei-Jahani  , Armeen Barghi  and Mohammed Kashem

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

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 [...]