Updates on Kidney Transplantation From the World Transplant Congress 2025
A summary of the World Transplant Congress 2025 highlights the advances reshaping kidney transplantation: machine perfusion moving toward clinical standard, new desensitization regimens for highly sensitized patients, anti-CD38 therapy for rejection, costimulation blockade enabling calcineurin-inhibitor minimization, and AI-driven biomarkers for predicting graft outcomes.
Expanding access and organ utilization
Machine perfusion has progressed from an experimental approach toward an emerging clinical standard; a dedicated preservation-and-assessment trial confirmed its value in rescuing discarded kidneys and explored ex vivo organ repair, helping address the persistent organ shortage.
Desensitization and rejection
For highly sensitized candidates, novel desensitization regimens combining new proteasome inhibitors with anti-CD38 antibodies (daratumumab, felzartamab) effectively reduced donor-specific antibodies, enabling transplantation in previously ineligible patients. Anti-CD38 antibodies also show promise for treating antibody-mediated rejection.
Toward CNI minimization
Early trials of costimulatory blockade, including anti-CD28 agents, suggest a path toward safe tacrolimus minimization or withdrawal, part of a broader effort to improve long-term graft survival with new immunosuppressive strategies.
Precision medicine
A growing emphasis on novel endpoints and biomarkers reflects a shift toward precision transplantation, with artificial-intelligence tools integrating multiomics data emerging as powerful predictors of graft outcomes.
Category
Transplant
Source
Transplantation
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