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Clinical Advances in Kidney Transplantation
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Clinical Advances 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: 19 September 2025 | Viewed by 611

Special Issue Editors

Dr. Florin Ioan Elec

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Guest Editor
1. Department of Urology, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
2. Clinical Institute of Urology and Renal Transplantation, Iuliu Hațieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
Interests: kidney transplantation; oncologic urology; nephrology
Dr. Oana Antal

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Guest Editor
1. Department of Anesthesiology and Intensive Care, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
2. Clinical Institute of Urology and Renal Transplantation, Iuliu Hațieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
Interests: kidney transplantation; critical care medicine; intensive care medicine

Special Issue Information

Dear Colleagues,

Kidney transplantation remains the gold standard treatment for end-stage renal disease, offering patients improved quality of life and survival outcomes compared to dialysis. However, this field continues to evolve, with significant advancements in immunosuppression, donor allocation strategies, and recipient management. The integration of precision medicine, innovative diagnostic tools, and emerging technologies like artificial intelligence and machine learning is reshaping clinical practices and decision-making in transplantation.

As Guest Editors of this Special Issue of the Journal of Clinical Medicine, “Clinical Advances in Kidney Transplantation”, we are delighted to invite you to contribute to this focused collection. Dr. Oana Antal, as co-editor, brings her expertise in intensive care and hemodynamics, providing a critical perspective on kidney transplantation’s perioperative and hemodynamic aspects, which are essential yet often underexplored in advancing transplant success.

This Special Issue aims to explore the latest developments in kidney transplantation, including advancements in donor risk stratification, immunosuppression, post-transplant care, and the integration of emerging technologies. Your expertise and insights are invaluable in shaping this comprehensive overview of the field and its future directions.

We welcome original research and reviews that address transplantation's challenges and opportunities. Together, let us advance the science and practice of kidney transplantation and improve patient outcomes.

Dr. Florin Ioan Elec
Dr. Oana Antal
Guest Editors

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
  • immunosuppression
  • graft survival
  • donor risk assessment
  • post-transplant management
  • rejection and tolerance
  • precision medicine in transplantation

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Published Papers (2 papers)

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Research

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12 pages, 2309 KiB  
Article
Validation of Kidney Donor Profile Index and Estimated Post-Transplant Survival Scores in an Eastern European Transplantation Center—A Seven-Year Retrospective Observational Study
by Florin Ioan Elec, Tudor Moisoiu, Matei Florin Negrut, Robert Simon, Alina Daciana Elec, Adriana Milena Muntean, Georgeta Horciag, Ana Maria Sitaru, Andreea Liana Rachisan, Gabriel Oniscu and Oana Antal
J. Clin. Med. 2025, 14(10), 3540; https://doi.org/10.3390/jcm14103540 - 18 May 2025
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Abstract
Background/Objectives: The Kidney Donor Profile Index (KDPI) is an important metric for evaluating the quality of donor kidneys and predicting post-transplant outcomes. The Estimated Post-Transplant Survival (EPTS) score is a tool for estimating kidney transplant candidates’ long-term survival. However, their validity in Eastern [...] Read more.
Background/Objectives: The Kidney Donor Profile Index (KDPI) is an important metric for evaluating the quality of donor kidneys and predicting post-transplant outcomes. The Estimated Post-Transplant Survival (EPTS) score is a tool for estimating kidney transplant candidates’ long-term survival. However, their validity in Eastern European cohorts is yet to be explored. This study aimed to evaluate the predictive accuracy of the KDPI and EPTS in a local cohort. Methods: We conducted a seven-year retrospective observational study at a high-volume transplant center in Romania. Data from 353 patients who received kidney transplants from brain-dead donors (DBDs) between 2017 and 2023 were analyzed. The KDPI scores were stratified into <35%, 35–85%, and >85%, while EPTS was stratified into <20%, 20–60%, and >60%. Primary outcomes included one-, three-, and five-year post-transplant graft function as estimated by eGFR, while secondary outcomes involved patient and graft survival rates at one, three, and five years. Results: Graft function and survival rates were significantly lower with increasing KDPI and EPTS scores, reinforcing the utility of both scores in clinical decision-making. Conclusions: Despite their limitations, KDPI and EPTS remain valuable predictors in our patient population. Full article
(This article belongs to the Special Issue Clinical Advances in Kidney Transplantation)
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Review

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20 pages, 818 KiB  
Review
Complement in Antibody-Mediated Rejection of the Kidney Graft: From Pathophysiology to Clinical Practice
by Bogdan Marian Sorohan, Dorina Tacu, Constantin Gîngu, Silviu Guler-Margaritis, Bogdan Obrișcă, Maria-Daniela Tănăsescu, Gener Ismail and Cătălin Baston
J. Clin. Med. 2025, 14(8), 2810; https://doi.org/10.3390/jcm14082810 - 18 Apr 2025
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Abstract
Antibody-mediated rejection (AMR) is a leading cause of kidney graft failure. Complement activation is involved in the AMR process. Our aim is to provide the current understanding of the pathophysiology related to complement-mediated injury in AMR, to present the current evidence regarding complement [...] Read more.
Antibody-mediated rejection (AMR) is a leading cause of kidney graft failure. Complement activation is involved in the AMR process. Our aim is to provide the current understanding of the pathophysiology related to complement-mediated injury in AMR, to present the current evidence regarding complement blockade in AMR management, and to point out emerging therapies and future directions in this area. The complement system plays an important role in the onset and progression of AMR. There is a balance between complement-dependent and -independent mechanisms in the development of rejection lesions. Classic and leptin pathways are involved in this process. C4d positivity is no longer a mandatory feature for AMR diagnosis but remains an independent predictor of negative outcomes. The current evidence regarding AMR treatment is limited. Terminal and proximal complement blockade has gained recognition in clinical practice. Eculizumab and C1 inhibitors are effective in the treatment of AMR as adjuvant therapies to the standard of care. The availability of novel complement inhibitors will lead to more effective and tailored treatment strategies. Full article
(This article belongs to the Special Issue Clinical Advances in Kidney Transplantation)
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