Welcome to the January 2026 issue of Transplantation, and to a new year that begins with remarkable momentum across our field.
Xenotransplantation continues to move decisively toward clinical implementation, with FDA-authorized clinical trials now on the horizon. In this issue, we feature a large-animal study that examines proteinuria in kidney xenotransplantation—an ongoing challenge not only from a metabolic standpoint, but also for its potential implications for immunosuppression when key therapeutic targets may be lost.
Continuing on this theme, an authoritative review contrasts inflammatory responses in allo- versus xenografts, delineating the complex and interdependent relationships among inflammation, coagulation dysregulation, and innate and adaptive immune pathways.
We are also pleased to present the first global, prospective, multicenter analysis comparing surgical approaches for living donor liver transplantation. Drawing on the International LDLT Registry, this report demonstrates the advantages of robotic techniques over laparoscopic and open approaches, providing timely evidence that can help inform clinical practice, shape evolving guidelines, and advance donor safety worldwide.
As the number of older adults benefiting from allogeneic hematopoietic stem cell transplantation (allo-HSCT) continues to rise, defining appropriate selection criteria becomes increasingly important. A contribution in this issue reinforces a key principle: advanced age alone should not serve as an exclusion criterion. With thoughtful patient selection and optimized transplant strategies, allo-HSCT can be both safe and effective in carefully selected elderly patients.
Finally, persistent socioeconomic disparities in transplant outcomes are examined through an innovative linkage of Organ Procurement and Transplantation Network data with estimated individual household income derived from the American Community Survey. This analysis shows that lower individual income is associated with a higher risk of all-cause graft failure—an important reminder that improving outcomes also requires confronting inequities in access, resources, and longitudinal support.
These papers, along with many others addressing pressing scientific, clinical, and societal questions, comprise the January 2026 issue of Transplantation. We hope you enjoy the issue, and we wish you a productive and rewarding year ahead.
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