Ageing and Well-Being in Transplantology: Clinical Progress and Quality of Life

Dear Colleagues,

Advances in organ transplantation have substantially improved graft and patient survival, transforming many previously fatal conditions into chronic states requiring long-term, multidisciplinary care. As increasing numbers of recipients live for many years after kidney, liver, heart, lung, pancreas or multi-organ transplantation, new challenges and opportunities are emerging. Clinical priorities are expanding beyond graft survival alone towards prevention of chronic disease, preservation of physical and functional capacity, maintenance of independence and healthy ageing.

Solid organ transplant recipients face a complex combination of transplant-specific and general health risks. Long-term immunosuppression, cardiometabolic complications, post-transplant weight gain, diabetes, dyslipidaemia, frailty, sarcopenia and reduced physical capacity may all influence healthspan and quality of life. The risk of selected malignancies is also increased after transplantation, making preventive strategies, appropriate screening, vaccination where indicated, sun protection and modification of behavioural risk factors particularly relevant. At the same time, ageing of the transplant population raises important questions about functional recovery, resilience, multimorbidity and how best to preserve participation in family, professional and social life.

These challenges create opportunities to integrate lifestyle medicine and preventive care more systematically across the transplant journey, from pre-transplant optimisation and prehabilitation through early post-transplant recovery to long-term ambulatory follow-up. Nutrition, physical activity, restorative sleep, stress management, avoidance of harmful substances and positive social connection are central domains of lifestyle medicine that may contribute to better long-term health. Other relevant areas include rehabilitation, maintenance of muscle mass and functional capacity, nature exposure and outdoor activity, behavioural change, self-management and adherence.

Longevity after transplantation should therefore be considered not only in terms of years of survival but also in relation to healthspan, preserved function, independence and well-being. Research is needed to determine which preventive and lifestyle interventions are effective, safe, feasible and sustainable in different transplant populations and at different stages of the transplant pathway.

This Special Issue aims to present and disseminate recent clinical research addressing the evolving challenges and opportunities in organ transplantation, with particular emphasis on lifestyle medicine, preventive care, healthy ageing and healthspan. We welcome original research, systematic reviews, meta-analyses and clinically relevant reviews addressing kidney, liver, heart, lung, pancreas and multi-organ transplant recipients. Contributions examining patient-centred outcomes, functional health, modifiable risk factors, multidisciplinary interventions and strategies for improving long-term health after transplantation are particularly encouraged.

Topics of interest include, but are not limited to:

• Nutrition and metabolic health after transplantation;
• Physical activity, exercise, rehabilitation and prehabilitation;
• Frailty, sarcopenia, functional capacity and healthy ageing;
• Healthspan, longevity and quality of life across the ageing trajectory;
• Cardiovascular and metabolic risk prevention;
• Obesity and post-transplant metabolic complications;
• Sleep, stress, mental well-being and social connection;
• Nature exposure, outdoor activity and restorative environments after transplantation;
• Behaviour change, self-management and lifestyle adherence;
• Personalised and multidisciplinary lifestyle interventions;
• Preventive care and clinical management of older and ageing transplant recipients;
• Patient-reported outcomes and long-term functional outcomes.

Dr. Olga Maria Rostkowska
Prof. Dr. Leszek Domański
Prof. Dr. Krzysztof Mucha
Guest Editors

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