Kidney transplantation continues to face significant immunological challenges, including chronic allograft dysfunction, desensitization in highly sensitized patients, and the ongoing need to balance effective immunosuppression with infection risk. Despite advances, current treatment protocols often fall short of delivering personalized, durable solutions, sustaining ongoing debates in both clinical practice and research.

Recent developments — including the integration of precision medicine, artificial intelligence, and novel biomarkers — have opened promising new pathways. However, translating these findings into clinically actionable strategies remains a key unmet need.

This Research Topic aims to bring together multidisciplinary insights that address both the clinical realities and immunological underpinnings of kidney transplantation. We seek contributions that highlight innovative immunomodulatory strategies, mechanistic studies, and translational advances. Focus areas include tolerance-inducing protocols, cell-based therapies, immune monitoring tools, and systems-level approaches involving the microbiome and metabolomics. By aligning immunological mechanisms with patient-centered outcomes, this Topic aims to promote transformative advances in transplant care.

We welcome submissions that explore the following themes:

-Tolerance-inducing protocols and cell-based therapies
-Mechanistic insights into alloimmune responses and immune regulation
-Personalized immunosuppressive approaches guided by immune profiling
-Novel immunosuppressive agents and delivery methods
-Strategies to address chronic allograft dysfunction
-Integration of microbiome, metabolomics, and biomarker discovery in clinical decision-making
-AI and machine learning in immunosuppression customization and risk prediction

We invite Review Articles, Original Research, Perspectives, and Case Series that contribute to either clinical practice or foundational immunology, including both experimental and translational studies.

Conflicts of Interest Declaration : Dr. Louise Benning receives funding for dd-cfDNA testing: CareDx, iMDx Honoraria/Travel Support: Astellas, CareDx, Chiesi, Vifor

Are you interested in contributing a manuscript to this Research Topic?

Breaking Immunological Barriers and Redefining Frontiers in Kidney Transplantation