World Journal of Transplantation

Liver transplantation (LT) has achieved excellent short-term outcomes; however, long-term survival remains limited by cardiovascular disease, now a leading cause of late mortality in transplant recipients. Immunosuppressive therapy is a major contributor to this risk through both direct vascular toxicity and indirect metabolic effects. This review examines the clinical impact of immunosuppression…

BACKGROUND Patient education remains an underdeveloped component of care in abdominal transplantation. Despite the benefits of improved health literacy, most educational materials remain inaccessible to the average patient. AIM To evaluate the impact of educational booklets on comprehension, anxiety, satisfaction, and healthcare utilization among abdominal transplant recipients and donors. METHOD…

BACKGROUND Kidney transplant recipients (KTR) have impaired immune responses to vaccination and remain at increased risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection despite mRNA coronavirus disease 2019 (COVID-19) vaccination. Data from rural and medically underserved transplant populations remain limited. AIM To evaluate serologic response to a two dose mRNA SARS-C…

BACKGROUND Mesenteric leiomyosarcoma, a rare tumor originating from the smooth muscle of the mesentery, that may require treatment with gemcitabine based chemotherapy in advanced stages. Gemcitabine usage has been associated with the development of thrombotic microangiopathy, a risk which can be increased by concurrent use of sirolimus. CASE SUMMARY We present the case of a young Caucasian woman …

We read the comments by Favi and Morabito, published in the recent issue of the World Journal of Transplantation , about our recently published paper and am concerned that our paper is being misrepresented as a debate on donor nephrectomy techniques. Ours is a surgical paper, in which we discussed selection criteria for right kidneys and how to best utilize the vein, because it is the vein length…

BACKGROUND Tissues from septicemic donor are considered contraindication for transplantation. However, a definite evidence is lacking to link these corneas as a potential source of post-transplantation infection. AIM To assess corneal tissue microbiology in septicemic donors and correlate postmortem blood cultures with ocular isolates to determine transplant suitability. METHODS A bicentric cross…

Hepatic ischemia-reperfusion injury (HIRI) is a significant contributor to liver dysfunction and failure following liver transplantation and hepatic surgical procedures. With the increasing global incidence of end-stage liver disease necessitating transplantation, strategies to mitigate HIRI have become important. Ferroptosis, a regulated form of cell death characterized by iron dependency and li…

BACKGROUND Donor-specific antibodies (DSA) against human leukocyte antigens (HLA) are associated with increased immunologic risk in kidney transplant recipients (KTR). However, outcomes among DSA-positive patients are highly variable. Traditional markers, such as DSA class and mean fluorescence intensity (MFI), often fail to capture the multidimensional nature of immunologic risk. AIM This retros…

Glucagon-like peptide-1 (GLP-1)/glucose-dependent insulinotropic polypeptide receptor agonists’ use as a weight loss tool is gradually expanding. They can be used as bridging therapies to reduce weight in potential living donors for liver transplantation and improve graft quality. A living donor with high body mass index is likely to be declined in most living donor programs due to concerns about…

BACKGROUND Patients undergoing liver transplantation often develop multiple hemostatic abnormalities requiring dynamic transfusion and antifibrinolytic support; however, how hemostatic status changes over time during liver transplant surgery is not well defined, limiting clinicians’ ability to anticipate and manage hemostatic instability. AIM To describe the distribution of intraoperative coagula…

In this editorial, we comment on the article by Muñoz-Serrano et al published in the World Journal of Transplantation . Chronic kidney disease (CKD) is one of the most frequent and severe complications after liver transplantation (LT), threatening long-term survival beyond graft-related issues. Its pathogenesis is multifactorial, combining calcineurin inhibitor (CNI) nephrotoxicity with pre- and …

In this review summarizes studies addressing a critical and long-overlooked vulnerability in simultaneous pancreas-kidney transplantation (SPKT): Perioperative metabolic instability during the transition from graft ischemia to endocrine recovery after reperfusion. Despite the central role of glycemia in pancreatic graft viability, intraoperative glucose management has remained largely empirical, …

Obesity and its complications, including metabolic dysfunction-associated steatohepatitis, are now major drivers of liver transplantation (LT) worldwide. Therefore, transplant surgeons are increasingly encountering patients who have undergone bariatric surgery prior to LT. Past reports suggested bariatric surgery does not adversely affect LT outcomes such as perioperative complications or surviva…

Pediatric solid organ and hematopoietic stem cell transplant recipients paradoxically experience accelerated immune aging despite chronological youth, establishing a paradigm with profound implications for cancer risk and long-term outcomes. This comprehensive review synthesizes current evidence demonstrating how transplantation-related factors, anti-thymocyte globulin-mediated T cell depletion, …

Infections remain a leading cause of morbidity and mortality in patients with cirrhosis and liver transplantation (LT). Vaccination is underutilized despite proven benefits, and responses are often blunted by cirrhosis-associated immune dysfunction and post-transplant immunosuppression. This review synthesizes current evidence and recent advances in vaccination strategies for adult LT recipients,…

BACKGROUND Standard immunosuppressive regimens result in low rejection rates in the first year after transplantation. However, long-term survival rates after renal transplantation remain relatively poor and are associated with drug-induced side effects. AIM To assess the effects of switching from traditional mycophenolate mofetil (MMF) combined with steroids and tacrolimus to a low-dose regimen o…

BACKGROUND Procurement biopsy remains widely used in deceased donor kidney transplantation, yet its value is uncertain in kidneys with preserved renal function. Concerns persist regarding sampling error, interpretive variability, and the potential for biopsy findings to contribute directly to organ discard. Whether procurement biopsy improves decision-making or graft outcomes in donors with norma…

Induction immunosuppression in kidney transplantation requires a longitudinal perspective that extends beyond early rejection prevention to encompass long-term graft durability and patient safety. In response to the recent propensity score-matched study by Chukwu et al , complementary considerations are provided that address two underrecognized dimensions: Cumulative immunological burden and the …

BACKGROUND Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare malignancy that may lead to complex postoperative complications, including brochobiliary fistula (BBF). CASE SUMMARY We report a 21-year-old patient with pulmonary metastatic FL-HCC, previously treated with multiple liver ablations, left lung wedge resections, and thoracic radiation, who subsequently developed a right-sided BBF.…

BACKGROUND Thoracic organ procurement procedures have been standardized for decades, and serious organ injury during procurement is considered rare. However, when injuries do occur, they may result in irreversible loss of transplantable organs. CASE SUMMARY We report a rare case of unintentional donor heart injury caused by transdiaphragmatic liver core needle biopsy using a Tru-Cut–type device d…