Solid organ transplantation remains the definitive treatment for end-stage organ failure, markedly improving survival and quality of life. However, the traditional approach to post-transplant care relies on standardized immunosuppressive regimens that do not account for patient-specific biological differences, exposing recipients to significant risks of rejection, infection, malignancy, and drug-related toxicity. Recent advances in genomics, molecular profiling, and digital health technologies have catalyzed the transition toward precision medicine in transplantation. This paradigm leverages integrated multi-omics data, predictive biomarkers, and computational modeling to stratify risk, customize immunosuppression, and optimize monitoring. Despite notable progress in identifying molecular signatures and developing noninvasive diagnostic tools, several challenges persist, including clinical implementation, regulatory barriers, and the need for robust validation. Understanding the opportunities and limitations of precision approaches is therefore essential for translating bench discoveries into improved real-world outcomes for transplant recipient. We invite authors to share real-world applications and innovative technologies, to create a multidisciplinary collaboration.

The principal aim of this Research Topic is to advance the scientific understanding and clinical application of precision medicine in solid organ transplantation. By showcasing original research, high-level reviews, and real-world case studies, the collection seeks to define the current landscape, elucidate mechanisms underlying inter-individual differences, and delineate how emerging technologies can be leveraged for individualized care. Specifically, the goal is to explore the integration of genomics, transcriptomics, proteomics, metabolomics, and advanced machine learning algorithms into clinical practice for the stratification of transplant recipients, prediction of adverse events, and dynamic tailoring of immunosuppressive therapies. This initiative also seeks to address the ethical, logistical, and regulatory challenges inherent in adopting precision approaches, fostering multidisciplinary dialogue among clinicians, researchers, bioinformaticians, and ethicists. Ultimately, the topic aspires to identify knowledge gaps, highlight innovative methodologies, and inspire collaborative efforts that will accelerate the translation of precision strategies into tangible improvements in graft survival, patient safety, and overall quality of life for recipients of kidney, liver, heart, and lung transplants.

This Research Topic invites submissions that span all aspects of precision medicine relevant to solid organ transplantation. Eligible contributions include original articles, systematic reviews, perspectives, and translational studies focusing on:

• Development and application of omics-derived biomarkers for rejection, tolerance, and infections

• Integration of artificial intelligence and machine learning for predictive modeling and patient phenotyping

• Digital health innovations and noninvasive monitoring strategies

• Novel immunosuppressive regimens and personalized therapeutic algorithms

• Ethical, legal, and social implications of applying precision tools in clinical practice

Multidisciplinarity is encouraged, encompassing input from transplant clinicians, basic scientists, computational biologists, engineers, and policy makers. The scope explicitly emphasizes translational potential, with the intention of bridging the gap between laboratory discoveries and advances at the bedside, ultimately aiming to improve patient outcomes through implementation of precision medicine in routine transplant care.

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Precision Medicine in Solid Organ Transplant