Precision Medicine in Kidney Transplantation: Refining Clinical and Surgical Decision-Making from Donor Selection to Long-Term Graft Outcomes

Kidney transplantation is a transformative therapy for end-stage renal disease, offering improved survival and quality of life. Despite its success, persistent issues such as organ scarcity, delayed graft function, rejection episodes, and complications related to chronic immunosuppression continue to challenge clinicians. At the same time, transplant surgeons and multidisciplinary teams are confronted with an expanding volume of complex biological and imaging data that is rarely integrated into real-time clinical decision-making. Traditional approaches in donor-recipient selection, surgical technique, and post-transplant care largely depend on generalized protocols and population-based data, which may overlook individual variability. Recent evidence highlights the potential of precision medicine, integrating genetic, molecular, and environmental information to refine the transplantation process. Emerging studies in genomics, multi-omics, advanced imaging, and artificial intelligence have begun to shed light on their roles in improving organ allocation and predicting post-transplant complications.This Research Topic aims to explore how precision medicine can revolutionize every stage of kidney transplantation. The primary goal is to evaluate and promote strategies that harness multi-layered data—spanning donor selection, surgical intervention, and individualized immunosuppression—to enhance graft survival, reduce complications, and optimize clinical outcomes. Specific objectives include investigating new biomarkers for donor organ viability, developing predictive models for delayed graft function and rejection, testing AI-driven tools that support personalized surgical planning and post-operative care, and evaluating how precision-guided strategies influence intraoperative decision-making and post-transplant management.Topics of interest include but are not limited to:- Advanced genetic and multi-omics approaches for donor and recipient profiling- Novel biomarkers and non-invasive diagnostics for graft assessment and monitoring- AI and machine learning applications in predictive analytics and clinical decision support- Innovations in imaging, anatomical mapping, and surgical planning, including augmented and virtual reality- Personalized immunosuppression strategies and optimization of post-transplant care- Approaches to optimize organ allocation and utilization of marginal donors- Comparative studies of open, laparoscopic, and robotic transplantation approaches guided by individualized risk assessment- Ethical, regulatory, and implementation challenges of precision medicine and AI-driven decision-making in kidney transplantation Topic editors: Alessio Pecoraro, Alicia López-Abad, Angelo Territo Source: https://www.frontiersin.org/research-topics/76453/precision-medicine-in-kidney-transplantation-refining-clinical-and-surgical-decision-making-from-donor-selection-to-long-term-graft-outcomes