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Sustaining Success Through Innovation in Kidney Transplantation
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Sustaining Success Through Innovation in Kidney Transplantation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 973

Special Issue Editor

Prof. Dr. Junji Uchida

E-Mail Website
Guest Editor
Department of Urology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
Interests: kidney transplantation; long-term graft survival; immunosuppression; organ preservation; complication after kidney transplantation

Special Issue Information

Dear Colleagues,

Kidney transplantation has undergone remarkable progress in recent decades, with significant improvements supporting both patient survival and quality of life. Nevertheless, the field continues to encounter enduring challenges, such as ensuring long-term graft viability, managing post-transplant complications, and addressing donor organ shortage. These pressing issues necessitate the development of innovative strategies to promote sustainable progress in transplantation.

This Special Issue aims to illuminate recent advancements and explore novel strategies that address these critical challenges in kidney transplantation, offering a comprehensive review of cutting-edge research and clinical innovations that can potentially transform the field of transplantation.

Our focus encompasses a wide spectrum of topics, including advancements in immunosuppressive therapies and the use of biomarkers for effective graft monitoring. Furthermore, we explore the potential of xenotransplantation as a viable solution to organ scarcity. We also examine mechanisms such as donor exchange programs, which offer viable alternatives to expand the donor pool and increase access to transplantation. Additionally, we address key issues related to post-transplant complications, aiming to improve long-term outcomes.

We invite submissions of original research articles and comprehensive review papers that contribute to the advancement of kidney transplantation. Submissions should provide valuable insights into innovative approaches poised to shape the future of transplantation, improving both patient outcomes and graft longevity.

Prof. Dr. Junji Uchida
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • kidney transplantation
  • long-term graft survival
  • immunosuppression
  • organ shortage
  • post-transplant complication

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

9 pages, 736 KiB  
Article
Comparative Analysis Between Insulated Gel Bags and Direct Cooling for Temperature Management During Kidney Transplant Vascular Anastomosis
by Yuichi Machida, Tomoaki Iwai, Kazuya Kabei and Junji Uchida
J. Clin. Med. 2025, 14(7), 2368; https://doi.org/10.3390/jcm14072368 - 29 Mar 2025
Viewed by 275
Abstract
Background/Objectives: Ischemic time plays a crucial role in graft function and survival during kidney transplantation. Cooling methods, including cold perfusion and ice slush, are predominantly applied to preserve the kidney, but they may cause uneven cooling and complications. The Organ Pocket®, [...] Read more.
Background/Objectives: Ischemic time plays a crucial role in graft function and survival during kidney transplantation. Cooling methods, including cold perfusion and ice slush, are predominantly applied to preserve the kidney, but they may cause uneven cooling and complications. The Organ Pocket®, an insulated gel bag, has been introduced as an alternative cooling method. However, no studies have compared renal temperature changes between the Organ Pocket® and conventional cooling methods. Methods: We retrospectively analyzed 49 cases of living-donor kidney transplantation. Among these, 33 received kidney grafts preserved with the Organ Pocket® (OP group), and 16 underwent conventional cooling (control group). Renal surface temperatures were recorded at 5 min intervals during vascular anastomosis using thermography. Postoperative renal function was assessed with estimated glomerular filtration rate (eGFR), serum creatinine (sCr), and liver-type fatty acid-binding protein (L-FABP) levels. Results: The OP group demonstrated significantly higher renal surface temperatures than the control group during vascular anastomosis (p < 0.05). Renal surface temperature before reperfusion was 20.4 °C ± 2.5 °C and 17.2 °C ± 2.5 °C in the OP and control groups, respectively. No significant differences in postoperative eGFR, sCr, and L-FABP levels; delayed graft function (DGF); or acute rejection rates were observed between the groups. Conclusions: The Organ Pocket® effectively stabilized renal temperatures during vascular anastomosis without direct cooling, thereby reducing continuous manual cooling requirements. Short-term renal function outcomes were comparable between groups; however, the Organ Pocket® may improve surgical efficiency and be particularly beneficial in robot-assisted kidney transplantation. Further studies are warranted to investigate its long-term benefits. Full article
(This article belongs to the Special Issue Sustaining Success Through Innovation in Kidney Transplantation)
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20 pages, 6028 KiB  
Article
Immunosuppressant-Induced Alteration of Gut Microbiota Causes Loss of Skeletal Muscle Mass: Evidence from Animal Experiments Using Mice and Observational Study on Humans
by Mitsuru Tomizawa, Shunta Hori, Tatsuo Yoneda, Fumisato Maesaka, Sayuri Onishi, Takuto Shimizu, Kenta Onishi, Yosuke Morizawa, Daisuke Gotoh, Yasushi Nakai, Makito Miyake, Kazumasa Torimoto, Nobumichi Tanaka and Kiyohide Fujimoto
J. Clin. Med. 2025, 14(5), 1628; https://doi.org/10.3390/jcm14051628 - 27 Feb 2025
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Abstract
Background/Objectives: The number of older adults requiring a kidney transplant (KT) is increasing; hence, postoperative sarcopenia prevention is necessary. KT recipients require permanent oral immunosuppressants (ISs), and the gut microbiota (GM) plays a role in various systemic diseases. However, few studies have [...] Read more.
Background/Objectives: The number of older adults requiring a kidney transplant (KT) is increasing; hence, postoperative sarcopenia prevention is necessary. KT recipients require permanent oral immunosuppressants (ISs), and the gut microbiota (GM) plays a role in various systemic diseases. However, few studies have evaluated post-kidney transplantation frailty and the associations among ISs, GM, and muscle mass alterations. Therefore, we investigated the effects of ISs on GM and skeletal muscle mass in mice and human KT recipients. Methods: Mice were treated with six different ISs, and their skeletal muscle mass, GM diversity, and colonic mucosal function were assessed. Human KT recipients and donors were monitored before and after surgery for 1 year, and GM diversity was evaluated before and 1 month after surgery. Results: The abundance of Akkermansia, crypt depth, and mucin 2 expression were lower in tacrolimus- and prednisolone-treated mice. The psoas muscle volume changes at 1 month and 1 year after surgery were lower in KT recipients than in donors. Furthermore, the beta diversity was significantly different between the operative groups (p = 0.001), and the KT group showed the lowest Shannon index. Conclusions: The findings of this study indicate potential links among ISs, GM, and muscle mass decline. Further investigation is required to improve therapeutic strategies and patient outcomes. Full article
(This article belongs to the Special Issue Sustaining Success Through Innovation in Kidney Transplantation)
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