Transplantation Direct - July 2026
We welcome everyone to the July issue of Transplantation Direct, which is now available online. An important first bit of news is that the 2025 Impact Factor has increased appreciably to 2.2, and the CiteScore is now also higher at 3.6; thanks to all the authors who have contributed to the increasing impact of our journal.
As always, the July issue of Direct covers a wide range of topics in the transplantation field. Starting with organ transplant perfusion developments, we feature a present-day review article on the use of ex vivo normothermic machine perfusion to regenerate different damaged organ types, and an original study comparing the incidence of post-perfusion syndrome in liver transplant recipients receiving normothermic machine perfusion procured from controlled cardiac death donors versus those recipients receiving organs from brain-death donors. On the related topic of organ donation, we have an interesting article on the evolving paradigm of how the USA voucher-based non-directed living kidney donation system has influenced patterns and volumes of Good Samaritan donation; also, a live-liver donor analysis was performed on donor satisfaction and financial burden more than 2 decades after donation. Additionally related to donor-recipient issues, the latest data regarding outcomes in donor-recipient sex-mismatched liver transplant recipients is investigated. Turning to sensitized kidney transplant recipients, we have a report on long-term outcomes when using CTLA4-Ig plus anti-IL-6-directed therapy in highly-sensitized patients. Related to pancreas transplantation, there are studies on the impact pancreas transplant failure has on patient survival after simultaneous pancreas-kidney transplantation, and on an international survey aimed to determine the pancreas transplant use patterns in patients with Type 2 diabetes. In pediatric liver transplantation, an article proposes a strategy for optimizing Valganciclovir treatment for CMV in pediatric liver transplant recipients. For those interested in lung transplantation, authors present an experimental study looking at the early versus late use of the tyrosine kinase inhibitor, nintedanib, to treat chronic airway disease in a mouse orthotopic tracheal transplant model. We hope that you find this issue of Transplantation Direct informative and useful; full details of these articles are available in open access on our journal website.
Transplantation - Ethical Implementation of Organ Donation Following Medical Assistance in Dying
TTS 2026 Online Program with Abstract Presentations is now available!
Abstract Presenters now displaying in the online program
TTS 2026 - Help Celebrate the People Behind TTS
WHO Invitation
Invitation: public review of the draft global strategy on donation and transplantation
Background
Since 1987, the World Health Assembly has adopted a series of resolutions on this topic, including the World Health Organization Guiding Principles on Human Cell, Tissue and Organ Transplantation , updated through resolution WHA63.22 (2010) . Following WHO report A75/41 , which highlighted slow progress, the 77th World Health Assembly in 2024 adopted resolution WHA77.4 , calling on Member States to enhance the availability, ethical access and oversight of transplantation of human cells, tissues and organs. The resolution requested the development of a global strategy on the donation and transplantation of human cells, tissues and organs.
The WHO Secretariat has developed a first draft of the global strategy, drawing on a comprehensive literature review, a series of informal consultations with Non-State actors in official relations and WHO Collaborating Centres, and substantive contributions from relevant WHO Expert Advisory Groups.
The global strategy is intended to provide a shared direction for action and to support coordinated efforts to expand equitable access to transplantation treatment. It is not intended to be a detailed action plan or an implementation guideline. It is structured around the following sections: introduction and global situation overview, vision, objectives, strategic directions, and roles and responsibilities of Member States, WHO and partners.
WHO invites stakeholders to review this first version of the global strategy.
This public review aims to:
- Collect comments on the clarity, relevance and feasibility across diverse settings.
- Identify any outstanding factual issues, gaps or risks not already recognized that should be addressed.
Who should participate
Policy makers, regulators, service developers and providers, professional bodies, clinical and technical experts, scientists and researchers, civil society—including patient groups and advocates—international institutions and other organizations, as well as other interested parties.
How to submit feedback
Read the draft global strategy , then use the online form below to provide your feedback.
Deadline
The public review will remain open for six weeks, closing on 31 August 2026.
Next steps
Feedback received will be reviewed and incorporated into the final global strategy, which will be presented for adoption at the 80th World Health Assembly in 2027, through the Executive Board at its 160th session in January 2027.
Contact
For questions about the consultation process, please contact: transplantation@who.int
WHO would like to thank all reviewers in advance for their time, expertise and continued commitment to improving availability and ethical access to transplantation.
Read the draft global strategy , then use this online form to provide your feedback.
Upcoming Webinar Presentations
IPTA-ISOT Collaborative Webinar Series
‘Infections in Pediatric Kidney Transplant Recipients: Recurrent UTIs’
Transplantation Journal Highlights
Transplantation and Transplantation Direct - Behind the Paper
A PD-first Program in South Africa
Transplantation Improves Patient Survival in a PD-first Program in South Africa | Behind the Paper
In this Behind the Paper episode, Macey Levan, Social Media Editor for the Transplantation journals, interviews Robert Freercks and Kathryn Manning about their article:
Transplantation Improves Patient Survival in a PD-first Program in South Africa
This study examines kidney replacement therapy and transplantation access in a public sector renal program in South Africa. The discussion highlights the realities of a PD-first model, resource constraints, strict selection criteria, and the barriers that many patients face before reaching dialysis or transplantation.
Dr. Freercks and Kathryn Manning discuss findings from a cohort of patients with kidney failure referred to a public sector renal unit. While transplantation was associated with a major survival benefit, the episode underscores that many patients never receive kidney replacement therapy, and that even among those accepted into dialysis care, access to transplantation remains limited.
The conversation also explores the need for stronger data collection systems, increased treatment capacity, primary prevention, and policy advocacy to improve outcomes in resource-constrained settings.
Antiobesity Interventions
Antiobesity Interventions in Living Organ Donor Candidates | Behind the Paper
In this Behind the Paper episode, Macey Levan, Social Media Editor for the Transplantation journals, interviews Babak J. Orandi, MD, about his article:
Antiobesity Interventions in Living Organ Donor Candidates: Ethical and Policy Considerations
This perspective examines the ethical and policy considerations surrounding antiobesity interventions for living organ donor candidates. Dr. Orandi discusses how obesity can affect donor eligibility, why weight loss should be approached as long-term health management rather than a temporary threshold for donation, and how emerging therapies such as GLP-1 medications may influence donor evaluation.
The discussion explores key bioethical principles, including autonomy, beneficence, non-maleficence, and justice. It also addresses access to treatment, donor safety, legal and ethical concerns around payment for interventions, and the need for better long-term follow-up data and updated guidance as antiobesity therapies become more widely used.
Clarifying the Donation After Circulatory Death Process
Behind the Paper: Clarifying the Donation After Circulatory Death Process | Gabriel E. Gondolesi, MD, Marti Manyalich, MD, and Steven Potter, MD
In this Behind the Paper episode, Macey Levan, Social Media Editor for the Transplantation journals, interviews Gabriel E. Gondolesi, MD, Marti Manyalich, MD, and Steven Potter, MD about the key insights from:
📄 Clarifying the Donation After Circulatory Death Process: Addressing Misunderstandings, Correcting Misinformation, and Building Trust Through Education
Perspective Article
Published in Transplantation — May 2026
This episode focuses on donation after circulatory death, or DCD, and the importance of addressing misunderstandings, correcting misinformation, and building public trust through clear education. The conversation explores DCD practices, media narratives, standardized protocols, and the role of transplant professionals in explaining the process accurately to patients, families, clinicians, and the public.
The episode highlights:
- Why DCD is an important and established part of deceased organ donation
- How misinformation and negative media coverage can affect public confidence and donation rates
- The importance of a clear and evidence-based no-touch period after circulatory death
- Why withdrawal of life-sustaining treatment must remain independent from organ donation decisions
- The need for proper separation between patient care teams and organ procurement teams
- How standardized protocols and ICU clinician education can improve trust and consistency
- What can be learned from successful DCD programs, including Spain’s experience
Drs. Gondolesi, Manyalich, and Potter emphasize that DCD should be understood as part of standard, ethical, and carefully managed end-of-life and transplantation practice. The discussion underscores the need for transparency, education, and consistent clinical processes to strengthen trust and help close the gap between organ supply and demand.
Sequential NRP and NMP in DCD Liver Transplantation
Behind the Paper: Sequential NRP and NMP in Controlled DCD Liver Transplantation | Rohit Gaurav, FRCS
In this Behind the Paper episode, Macey Levan, Social Media Editor for the Transplantation journals, interviews Rohit Gaurav, FRCS, about the key insights from:
📄 Sequential In Situ Normothermic Regional Perfusion and Ex Situ Normothermic Machine Perfusion in Controlled Donation After Circulatory Death Liver Transplantation: A Retrospective Single-center Experience
Original Clinical Science — Liver
Published in Transplantation — 2026
This study examines the use of sequential normothermic regional perfusion, or NRP, and normothermic machine perfusion, or NMP, in controlled donation after circulatory death liver transplantation. The conversation explores how these technologies can support organ assessment, improve utilization of DCD livers, and help transplant teams make more informed decisions about marginal organs.
The episode highlights:
- Why DCD livers have historically been associated with higher risks, including ischemic cholangiopathy
- How NRP allows organs to be perfused and assessed after declaration of death
- The role of lactate clearance and liver enzyme levels in evaluating liver function
- How NMP can provide additional assessment for livers that do not meet NRP criteria
- Why sequential NRP-NMP may increase DCD liver utilization
- The early outcomes observed after implementation of this approach
- How this strategy has influenced national practice and protocol development in the United Kingdom
Dr. Gaurav discusses how sequential NRP and NMP may help expand the use of DCD livers while maintaining careful assessment of organ quality and transplant outcomes. The episode highlights the promise of machine perfusion technologies in improving organ utilization and addressing the ongoing gap between organ supply and demand.
Transplantation Direct - Viewpoint
Two Advanced Preservation Strategies. One Unanswered Question.
Viewpoint by editorial fellow Maria Florencia Fernandez, MD, on “Kidneys From Older Donors After Circulatory Death Plus Normothermic Regional Perfusion or Standard Rapid Retrieval Have Comparable Function in the Context of Ex Situ Oxygenated Hypothermic Machine Perfusion”
Emma F. Van de Geijn, Martin B.A. Heemskerk, Madeleine C. Van Dijk, Rutger M. Van Rooden, Fenna J. Van der Heijden, Femke H.C. De Goeij, Aiko P.J. De Vries, Ian P.J. Alwayn, Robert C. Minnee, Dorottya K. De Vries, Jeroen De Jonge, Volkert A.L. Huurman,
Transplantation Direct 12(6):p e1953, June 2026. | DOI: 10.1097/TXD.0000000000001953
Transplantation Journal - Social Media Content
Mitogen-activated Protein Kinase big Mitogen-activated Kinase-1 Mediates Protection in Liver Ischemia/Reperfusion Injury
Perspectives on the Implementation of a Peer-mentoring Program for Kidney Transplant Recipients From Underrepresented Groups: A Mixed-methods Study
Cancer Surveillance in Solid Organ Transplant Recipients With a Pretransplant History of Malignancy: Multidisciplinary Collaborative Expert Opinion
Transplantation Direct - Social Media Content
Practical Guide to Address Common Myths in the Pre– and Post–kidney Transplant Management of the Elderly Patient with Cancer: An Opinion Paper
Considerations in Liver Transplant Recipients Having Prior Roux-en-Y Gastric Bypass
ISUTx 2026 SOTA
Contact
Address
The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6
Canada
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