Transplantology

Purpose: This study aimed to examine post-traumatic growth, mindfulness, and quality of life in recipients after liver transplantation. Design and Methods: This study employs a descriptive and cross-sectional design. We collected data in an organ transplant center affiliated with a research and application hospital in Eastern Turkey. The sample in our study included a total of 292 liver transplant recipients. We collected data using a personal information form, the Post-Traumatic Growth (PTG) Inventory, the Mindfulness Scale (MS), and the Quality of Life Questionnaire (QoL) Short Form (SF-36). We performed data analysis using descriptive statistical methods and one-way analysis of variance. Results: Of the liver transplant recipients, 72.6% were between 45 and 64 years of age, 72.3% were female, and 56.5% had undergone liver transplantation more than 1 year prior. Liver transplant recipients scored between 64.89 and 97.85 on the negative subscales. Recipients scored between 32.70 and 44.72 on the positive subscales in QoL SF-36. The PTG and MS mean scores were 62.43 ± 20.31 and 62.35 ± 7.14, respectively. There was a positive correlation between positive QoL sub-dimensions and MS and PTG (p < 0.05). Conclusions: We found a positive and strong relationship between PTG and mindfulness; in addition, we found that an increase in both had the effect of improving QoL. We recommend developing strategies that increase PTG, and that mindfulness be performed to improve QoL among patients following liver transplantation.

Metabolic dysfunction–associated fatty liver disease (MAFLD) is now the leading indication for liver transplantation (LT), reshaping the landscape of transplant hepatology. Its close association with obesity, type 2 diabetes, cardiovascular disease, and extrahepatic malignancies poses unique challenges throughout the transplant continuum. This narrative review synthesizes current evidence across the pre-, peri-, and post-transplant spectrum, with a focus on practical implications for clinical management. We explore pre-transplant evaluation, focusing on how metabolic comorbidities, frailty, and organ allocation disparities intersect with emerging interventions such as GLP-1 receptor agonists, bariatric surgery, and structured weight loss programs. The increase in pediatric MAFLD, especially its early-onset aggressive form, indicates an evolving and concerning future burden on transplant programs. In the peri-operative and post-transplant periods, we address MAFLD recurrence, cardiometabolic complications, and the rising incidence of new cancers, particularly in relation to calcineurin inhibitor (CNI) exposure. Customized immunosuppression strategies, using mTOR inhibitors and mycophenolate mofetil, are discussed for their role in balancing graft protection with reducing cancer risk. We also review the application of machine perfusion technologies to optimize and expand the pool of steatotic donor livers. Future directions include the development of non-invasive diagnostic biomarkers, precision immunosuppression, and genomics-based risk stratification. Collectively, these insights emphasize the urgent need for multidisciplinary, patient-specific approaches and prospective, multicenter studies to optimize outcomes and equity in the era of MAFLD-driven liver transplantation.

Background/Objectives: Epitope-based matching has emerged as a refined approach for assessing donor–recipient compatibility in renal transplantation. However, limited data are available on HLA Class I epitope distribution among Indian patients, particularly from northern India, where substantial allelic diversity is known to influence immunological risk. Methods: This retrospective analysis evaluated HLA Class I single-antigen bead (SAB) antibody data from 218 consecutive renal-transplant candidates who tested positive for anti-HLA antibodies between July 2018 and September 2024. HLA Class I epitopes were identified and analyzed using MATCH IT Antibody Software (Immucor, version 1.5.0). Demographic variables and sensitization history (previous transplant, transfusion, pregnancy) were reviewed. Results: A total of 504 distinct epitopes were identified, with 65GK and 163LG emerging as the most frequent motifs. The predominance of these epitopes mirrors the high prevalence of alleles such as HLA-A*24 and HLA-B*35 reported in North-Indian populations. The data suggest a strong influence of regional allele architecture on the immunogenic epitope landscape. Conclusions: This study provides the first baseline characterization of HLA Class I epitope distribution among northern-Indian renal-transplant candidates. The findings emphasize the need for establishing population-specific HLA epitope databases and highlight the potential of epitope-based matching to enhance donor selection and minimize immunological risk in Indian transplantation programs.