1. Can sodium-glucose cotransporter 2 (SGLT2) inhibition preserve renal structure and function in de novo kidney transplant recipients? Protocol for a randomised, double-blind, placebo-controlled trial assessing the efficacy of dapagliflozin on kidney structure, function and safety in kidney transplant recipients in Norway-the DEAK study.

Kongerud IC, Midtvedt K, Solbu MD, Øvrehus MA, Eikrem Ø, Eide IA, Heldal K, Birkeland K, Åsberg A, Jenssen TG. BMJ Open, 2026. PMID: 42315275.

This is the published protocol for the Dapagliflozin Early After Kidney Transplantation (DEAK) study, a nationwide, investigator-initiated, single-centre, double-blind, placebo-controlled randomised trial in Norway. The rationale is that the pivotal SGLT2 inhibitor trials demonstrating slowed chronic kidney disease progression in high cardiovascular-risk populations all excluded transplant recipients, leaving a direct evidence gap. The plan is to enrol 330 de novo adult recipients aged 18–75 with an eGFR of at least 25 mL/min/1.73 m², randomised 1:1 to dapagliflozin 10 mg daily or placebo for three years, with recruitment at 6–8 weeks post-transplant and exclusion of those with recent rejection or active infection. The primary endpoint is the between-group difference in chronic eGFR slope over three years, using the European Kidney Function Consortium equation. Secondary and safety endpoints include measured GFR by iohexol clearance, urinary albumin/creatinine ratio, blood pressure, and infection rates, with embedded protocol biopsies (n=140) scored for inflammation and fibrosis and molecular substudies (n=50). A ten-year registry follow-up of eGFR slope, cardiovascular events, and graft and patient survival is also planned. No results are reported, as this is a design paper (EudraCT 2022-002428-10; NCT05788276). For UK practice, DEAK is the trial most likely to settle whether the cardiorenal gains seen in native CKD extend safely to transplanted kidneys, where infection and volume concerns currently temper enthusiasm.

2. Incidence and risk factors of post-transplant diabetes mellitus after kidney transplantation: a systematic review and meta-analysis.

Chen N, Chen Y, Liu Q, Shu Y. Front Endocrinol (Lausanne), 2026. PMID: 42267307.

This systematic review and meta-analysis pooled observational studies published after 2014 to estimate the incidence of post-transplant diabetes mellitus (PTDM) and identify its risk factors, searching PubMed, EMBASE, the Cochrane Library, and Web of Science up to 24 June 2024. Twenty-six studies from 15 countries, encompassing 8,727 participants, met inclusion criteria, with risk of bias assessed using the Newcastle-Ottawa Scale. The overall pooled incidence of PTDM was approximately 20%. Across the case-control studies, advanced age (OR 1.07, 95% CI 1.04–1.09), high body mass index (OR 1.23, 95% CI 1.08–1.39), and hypertriglyceridaemia (OR 1.01, 95% CI 1.00–1.02) emerged as significant risk factors. Cohort studies additionally identified high fasting plasma glucose, family history of diabetes, and hepatitis C virus infection as contributors, alongside age, BMI, and hypertriglyceridaemia. The authors highlight that BMI, glucose and lipid abnormalities, and HCV infection are modifiable targets. Heterogeneity and reliance on observational data are the principal caveats. The implication for UK transplant clinics is a clear case for systematic pre- and post-transplant metabolic screening and aggressive management of weight, lipids, and glycaemia, particularly in older recipients, given that roughly one in five develops PTDM.

3. Appropriate Risk Classification and Low-Dose Rituximab May Help Prevent Acute Rejection in ABO-Compatible Living Kidney Transplantation.

Fukuda M, Yokoyama T, Miki K, Tanaka K, Kamiyama M, Nakamura Y, Ishii Y. Transplant Proc, 2026. PMID: 42315390.

This single-centre retrospective study examined whether a risk-stratified, single low-dose of rituximab could prevent rejection in ABO-compatible (ABOc) living-donor kidney transplantation, a setting usually considered low-risk but where rejection still occurs. From 264 living-donor transplants performed between January 2015 and July 2024, the authors analysed 158 ABOc recipients after excluding ABO-incompatible cases and those receiving plasmapheresis or intravenous immunoglobulin. Twenty-eight recipients received a single 200 mg dose of rituximab 14 days before transplant and 130 received none, with the rituximab group carrying higher immunological risk—fewer related donors (32.1% vs 66.2%; p=0.002), more sensitised patients (67.9% vs 39.2%; p=0.011), and more donor-specific antibody (DSA) positivity (17.9% vs 1.5%; p=0.001). Despite this adverse risk profile, one-year acute rejection was numerically lower in the rituximab group (0% vs 10.8%; p=0.133), with a trend toward better rejection-free survival (log-rank p=0.075) and comparable one-year infection rates (21.4% vs 23.1%). In the small DSA-positive subgroup, all five treated patients remained rejection-free whereas both untreated patients rejected. The findings are limited by small numbers, retrospective design, and non-significant primary comparisons. For UK units, this supports exploring individualised desensitisation in selected immunologically higher-risk ABOc recipients rather than blanket dosing, pending prospective confirmation.

4. Preemptive Pharmacogenetics in Renal Transplantation: A Real-World Assessment of Pharmacogenetic Actionability.

Chastagner D, Arnion H, Monchaud C, Rérolle JP, Danthu C, Touré F, Picard N. Ther Drug Monit, 2026. PMID: 42307594.

This single-centre retrospective study assessed the real-world actionability of preemptive pharmacogenetic (PGx) testing performed during pretransplant evaluation, on the premise that immunosuppressants and their comedications have narrow therapeutic indices. The cohort comprised 110 adults who underwent pretransplant PGx assessment between 1 January 2022 and 30 June 2023, analysed across 16 pharmacogenes shared between the local panel and the ClinPGx guideline interface. Medication lists were captured pretransplant and post-transplant (or at last follow-up for waitlisted patients), with theoretical actionability defined as any actionable genotype and effective actionability as any actionable gene-drug pair under international guidelines. Theoretical actionability was near-universal at 109 of 110 patients (99%), while effective actionability applied to 29 of 110 (26%) at the pretransplant stage and rose to 19 of 41 (46%) post-transplant. The most frequent actionable pairs after transplant were CYP2C19–proton pump inhibitors (38%), CYP3A5–tacrolimus (25%), SLCO1B1–statins (13%), CYP2D6–tramadol (8%), and ABCG2–allopurinol (8%). Limitations include the single-centre retrospective design and hotspot-only coverage for some genes. The practical message for UK services is that embedding a PGx panel before listing could complement therapeutic drug monitoring—most obviously for CYP3A5-guided tacrolimus initiation—and flag relevant interactions across commonly co-prescribed drugs.

5. Improving Medication Adherence in Kidney Transplant Recipients Through Educational Intervention and Monitoring: A Randomized Clinical Trial.

Heinrich de Oliveira C, Schweig A, Gonçalves BP, Bissani CA, Saldanha MAP, Santini ADR, Riva E, Maestri HDP, Behr RV, Kroth LV. Transplant Proc, 2026. PMID: 42315392.

This randomised clinical trial tested whether a standardised educational intervention improves knowledge, immunosuppressant adherence, and clinical outcomes after kidney transplantation, given that non-adherence is a recognised driver of graft loss. Fifty-nine recipients were randomised, with the intervention group (n=31) receiving two structured health-education sessions using video, a booklet, and oral explanations, while the control group (n=28) received only routine discharge guidance. Knowledge was measured by questionnaire before and after the intervention, adherence by the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS), and clinical outcomes were followed for 12 months. The intervention markedly improved knowledge: one week after discharge the intervention group scored higher than controls (7.5 vs 5.1; p<0.001). However, BAASIS-measured adherence at six months did not differ significantly (45.2% vs 39.3%; p=0.697), and there were no significant between-group differences in rejection, infection, or survival over the first year. The trial is small and single-centre, limiting power for clinical endpoints. The takeaway for UK transplant follow-up is that education reliably raises understanding but, on its own, may not translate into measurable adherence or outcome gains—reinforcing the case for sustained, multimodal adherence support rather than one-off teaching.

6. Renal Outcomes in HBsAg-Positive Living Kidney Donors: A Retrospective Cohort Study.

Huang X, Yin S, Lin T. Transplant Proc, 2026. PMID: 42315391.

This retrospective cohort study evaluated the intermediate-term renal safety of using hepatitis B surface antigen-positive (HBsAg+) living kidney donors, a potential strategy to expand the donor pool. Among 415 living donors, 31 (7.5%) were HBsAg+, followed for a mean of 46.81 months versus 42.10 months for HBsAg- donors, with the primary outcome being change in renal function by serum creatinine and the incidence of eGFR below 45 mL/min/1.73 m². Baseline characteristics were comparable between groups. At last follow-up, serum creatinine was essentially identical (81.65 vs 81.64 µmol/L; p=0.996), and although the creatinine rise from baseline was marginally greater in HBsAg+ donors (12.53 vs 11.08 µmol/L), this was not statistically significant (p=0.060). Low eGFR was uncommon in both groups (3.2% vs 0.5%; p=0.543) with no cases of end-stage kidney disease, and multivariable analysis confirmed HBsAg+ status was not an independent predictor of creatinine increase (estimate 1.42, 95% CI −0.16 to 3.01; p=0.078), whereas hypertension and diabetes were. The retrospective design and small HBsAg+ subgroup limit firm conclusions. For UK practice, where donor scarcity is acute, these data offer cautious reassurance that carefully selected HBsAg+ living donors may be considered, with attention to comorbid hypertension and diabetes.

7. Opioid-Sparing Effects of Peripheral Nerve Blocks in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis.

Yun HJ, Kim DH, Chung MY, Min JY. Ann Transplant, 2026. PMID: 42298791.

This systematic review and meta-analysis evaluated whether peripheral nerve blocks (PNBs) reduce postoperative opioid requirements in adult kidney transplant recipients, who face heightened opioid-related risks. Following PRISMA methodology, the authors searched PubMed, EMBASE, the Cochrane Library, and Web of Science through April 2025, with the primary outcome being cumulative opioid use within 24 hours after surgery, expressed as intravenous morphine equivalents. Twelve studies met inclusion criteria and ten contributed to the quantitative synthesis. Pooled analysis showed PNBs significantly reduced 24-hour morphine consumption versus control analgesia, with a mean difference of −16.20 mg intravenous morphine equivalents (95% CI −24.66 to −7.74; p=0.0002). Heterogeneity was very high (I²=99%), reflecting variability in block techniques and perioperative regimens, but no study reported higher opioid use or increased adverse events in the PNB groups. The authors conclude PNBs are an effective opioid-sparing adjunct while calling for better-designed comparative trials. The substantial heterogeneity tempers the precision of the estimate. For UK practice, this strengthens the case for incorporating regional analgesia into multimodal, opioid-sparing enhanced-recovery pathways for transplant surgery.

8. Predicting long-term allograft outcomes in kidney transplant recipients using a machine learning approach: a 5-year retrospective cohort study.

Gao X, Chen J, Wang M, Li Z, Lou X, Chen J. Ren Fail, 2026. PMID: 42272126.

This retrospective cohort study developed and internally validated machine-learning models to predict five-year allograft survival in deceased-donor kidney transplant recipients, addressing the scarcity of prediction tools that integrate comprehensive pre- and post-transplant data with extended follow-up. The cohort comprised 940 adult deceased-donor recipients followed beyond five years. Two models were built: a pre-transplant model (KAPTOR-pre) using donor-recipient matching data, and a one-year landmark conditional model (KAPTOR-full) incorporating pre- and post-transplant parameters, pathology, and first-year laboratory markers. KAPTOR-full achieved excellent discrimination with an area under the receiver operating characteristic curve of 0.904, while KAPTOR-pre reached 0.813. In internal validation, both models showed higher C-index and improved risk stratification than established tools, including the Kidney Donor Profile Index (KDPI). The addition of first-year post-transplant data notably enhanced predictive accuracy over the pre-transplant model alone. The key limitation is that validation was internal only, so generalisability awaits independent multicentre testing. For UK practice, such models could eventually support more personalised surveillance and counselling, but they should be regarded as promising rather than deployable until externally validated against UK registry data.

Generated 2026-06-20 from PubMed search results for kidney transplantation published 2026-06-06 to 2026-06-20. Articles already recorded in prior issues were excluded. PubMed is the source of all metadata and abstracts.

1. Donor bone marrow together with recipient regulatory T cells induces chimerism without irradiation in kidney transplantation

Wekerle T, Muckenhuber M, Heinzel A, Weijler AM, David AF, Kainz V, Hu K, Mucha J, Mengrelis K, Reindl-Schwaighofer R, Böhmig GA, Watschinger B, Györi G, Soliman T, Salat A, Schwarz C, Muhm M, Heinze G, Wolzt M, Worel N, Fortschegger M, Lion T, Regele H, Berlakovich G, Halloran PF, Edinger M, Oberbauer R. Sci Transl Med, 2026. PMID: 42308328.

This controlled phase 1/2a trial (NCT03867617) tested whether chimerism-based tolerance could be induced in HLA-mismatched living-donor kidney transplantation without the recipient irradiation that limited earlier protocols. Six study patients received polyclonal recipient regulatory T cells together with donor bone marrow cells immediately after transplantation, under an immunosuppression backbone of thymoglobulin, belatacept, sirolimus, steroids, and short-course tocilizumab; the control group received none of the cell products or tocilizumab. Total leukocyte donor chimerism was detected in every study patient and in none of the controls, meeting the primary endpoint of higher chimerism in the study group (reported p = 0.001). Chimerism appeared across multiple lineages, reaching up to 4% within T cells. In three of the six study patients, immunosuppression could be reduced to belatacept monotherapy. Antidonor reactivity was diminished in in-vitro T-cell proliferation assays, and T-cell-receptor sequencing showed dampened expansion of antidonor clones, suggesting donor-specific downmodulation rather than global immunosuppression. The authors frame this strictly as proof of concept, and the sample of six patients with limited follow-up precludes any claim about durable tolerance or graft survival. For UK living-donor programmes the appeal is a tolerance strategy that avoids irradiation, but the approach remains experimental and far from routine adoption.

2. Evidence- and Consensus-based European Guideline for Immunosuppressive Therapy After Pediatric Kidney Transplantation

Grünewald A, Ahlenstiel-Grunow T, Arslan Z, Battelino N, Bot Rachisan AL, Bouts A, Busutti M, Cornelissen E, de Jong H, Dudley J, Düzova A, Eibensteiner F, Fichtner A, Fomina S, Gonzalez ML, Gulhan B, Grabitz C, Hogan J, Höcker B, Jeruschke S, Kanzelmeyer N, Kim JJ, Korst U, Labbadia R, Litwin M, Marks S, Melk A, Novljan G, Obrycki L, Oh J, Pape N, Pasini A, Patry C, Pohl M, Preka E, Prytula A, Rieger S, Schiffer M, Schild R, Seeman T, Stojanovic J, Testa S, Tönshoff B, Torres DD, Weber LT, Nothacker M, Pape L. Transplantation, 2026. PMID: 42308432.

This multi-society European guideline addresses the longstanding problem that immunosuppression after paediatric kidney transplantation rests on a thin evidence base, producing highly variable international practice and inconsistent uptake of individualised, newer-agent strategies. It was developed between January 2024 and December 2025 following the methodological manual of the German Association of Scientific Medical Societies, with input from the German societies for paediatric nephrology, nephrology, transplantation and paediatrics, the German Kidney Association, the International Pediatric Transplant Association, the European Society for Paediatric Nephrology, and the Cooperative European Paediatric Renal Transplant Initiative. The authors present it as a state-of-the-art set of recommendations grounded in the best available evidence supplemented by formal consensus. They emphasise that the formal consensus process carries particular weight where evidence is weak, inconclusive, or absent, with several recommendations resting on expert opinion alone. Because it is a consensus document, it reports no trial statistics, and clinicians should read the full text to gauge the strength of each individual recommendation. For UK paediatric transplant units it offers a contemporary European reference point that may help harmonise immunosuppressive protocols and support the adoption of individualised regimens.

3. Immunologic clustering of donor-specific antibodies and clinical outcomes in kidney transplant recipients

Al-Qurashi SH, Khalil MAM, Mahmood HHK, Alsharif MM, Alqurashi YF, Alghamdi L, Al-Ghamdi RA, Alsaedi ZA, Cruz AJD, Sadagah NM. World J Transplant, 2026. PMID: 42281880.

This single-centre retrospective study set out to refine immunological risk assessment in DSA-positive recipients, on the premise that conventional descriptors such as DSA class and mean fluorescence intensity (MFI) fail to capture the multidimensional nature of risk. Of 260 kidney transplants performed at King Fahad Armed Forces Hospital in Saudi Arabia, 151 recipients were DSA-positive, and 112 with complete immunological and follow-up data underwent unsupervised k-means clustering. The clustering variables were DSA class, number of DSA, cumulative MFI, early graft function (eGFR at four months), and HLA mismatch. Three distinct clusters emerged: a high-risk group (n = 58) combining Class I and II DSA with high antibody numbers and MFI, and the worst outcomes (acute rejection 6.9%, graft loss 6.9%, mortality 5.2%); an intermediate-risk group (n = 34) with predominantly Class II DSA and moderate MFI; and a low-risk group (n = 20) with isolated Class I DSA, low antibody burden, and excellent early graft function. Principal component analysis showed clear separation between the three groups, and the gradient of immunological burden tracked early post-transplant outcomes. The findings are limited by small numbers, a single centre, retrospective design, and short follow-up, so the thresholds should not yet guide practice. Nonetheless, the work signals that data-driven, multidimensional DSA profiling could eventually help UK units tailor monitoring and immunosuppression beyond MFI cut-offs alone.

4. Navigating the diagnostic ‘gray zone’: prospective evaluation of an integrated MRI-Biomarker model for renal allograft triage

Liao Z, Ma S, Liu Z, Tang H, Deng B, Zhang J, Yin T, Chen W, Darwish O, Wang Q, Chen G, Lee JM, Li Z. Ann Med, 2026. PMID: 42305025.

This prospective single-centre study addressed a familiar surveillance dilemma: deciding when subtle creatinine drift or ambiguous ultrasound findings justify an invasive allograft biopsy. The investigators developed a non-invasive tool combining advanced diffusion MRI with functional biomarkers in 120 renal transplant recipients, each of whom underwent multi-b-value diffusion-weighted imaging at 3.0 T within 48 hours before a biopsy. Patients were classified by biopsy result into a treatment-changed group (actionable active pathology) and a treatment-unchanged group (normal or only chronic, non-reversible lesions), and multivariable logistic regression with repeated stratified cross-validation and bootstrap resampling identified predictors. The cortical distributed diffusion coefficient and serum bicarbonate emerged as independent predictors of actionable pathology, and the integrated model achieved an AUC of 0.941 versus 0.563 for a standard clinical reference using eGFR, proteinuria, and ultrasound. A net reclassification improvement of 0.479 corresponded to correctly reclassifying 45.6% of patients, and model-derived high-risk status predicted subsequent graft functional decline, defined as a ≥30% fall in eGFR (log-rank p = 0.005). The authors are explicit that this is a preliminary, single-centre model requiring external validation before any clinical use. If validated, such non-invasive triage could help UK clinicians reduce unnecessary biopsies and focus invasive sampling on recipients most likely to harbour treatable pathology.

5. Rethinking procurement biopsy in donors with normal renal function: A barrier to kidney utilization without survival benefit

Sibulesky L, Kaufman DM, Bakthavatsalam R, Leca N, Perkins JD. World J Transplant, 2026. PMID: 42281884.

This national study used Organ Procurement and Transplantation Network data from 2014–2024 to ask whether procurement biopsy adds value in deceased-donor kidneys with preserved function (terminal eGFR ≥ 60 mL/min/1.73 m²). Among 158,365 recovered kidneys, 46.6% were biopsied, and biopsied kidneys were more than six times as likely to be discarded (28.2% vs 4.4%); biopsy findings alone accounted for discard of 5.9% of biopsied kidneys, more than half of which showed only minimal histological abnormalities. In a propensity-matched cohort of 52,094 transplants (26,047 per arm) with excellent covariate balance, a centre-clustered Cox model found biopsy associated with higher death-censored graft failure (HR 1.12, 95% CI 1.05–1.19). Biopsy prolonged cold ischaemia time by roughly 42 minutes and raised delayed graft function (30.6% vs 27.6%); sequential attenuation showed cold ischaemia and delayed graft function together explained about 55% of the survival association, pointing to a process-related rather than biological mechanism. The absolute effect was small — restricted mean survival time fell by about 0.03 years (≈12 days) at five years — and decision-curve analysis showed no added net benefit from biopsy beyond standard clinical variables. As an observational registry analysis it cannot establish causation and reflects US practice, but the convergence of methods is persuasive. For UK practice it reinforces a more selective, function-led approach to procurement biopsy that could lift utilisation of otherwise transplantable kidneys.

6. Effects of Donor Wage Reimbursement: Findings From the Living Donor Lost Wages Randomized Trial

Rodrigue JR, Fleishman A, Schold JD, Pavlakis M, Evenson AR, Duncan S, Mandelbrot DA, Baliga PK. Transplantation, 2026. PMID: 42308433.

This randomised trial tested whether reimbursing donor lost wages would increase living-donor kidney transplantation (LDKT), reasoning that financial loss deters both candidates and potential donors. Patients undergoing transplant evaluation were randomised to a maximum wage reimbursement of either $1,500 or $3,000 and encouraged to discuss the programme within their social networks, then compared with matched historical controls using multivariable logistic regression. In the primary analyses, access to any reimbursement was not significantly associated with LDKT (adjusted OR 0.85, 95% CI 0.39–1.85, p = 0.68) or with having at least one donor evaluated within a year (adjusted OR 1.07, 95% CI 0.76–1.50, p = 0.70). The reimbursement level made no difference either, with no significant contrast between the $1,500 and $3,000 caps. An exploratory analysis that extended follow-up to account for COVID-related shutdowns did associate reimbursement with higher odds of LDKT (adjusted OR 2.16, 95% CI 1.12–4.18, p = 0.02), hinting that effects may emerge over longer horizons. The authors conclude that wage reimbursement at these levels was insufficient on its own to expand living donation, with the historical-control design and pandemic disruption as key caveats. For the UK, where removing financial disincentives to donation is an active policy lever, the message is that reimbursement likely needs to sit within a broader support package rather than stand alone.

7. Real-world economic comparison of preemptive kidney transplant vs maintenance dialysis in patients with end-stage kidney disease

Schold JD, Potukuchi P, Voss J, Preblick R, Sienko D, Yu T, Noshad S, Boame N, Devlin A. J Med Econ, 2026. PMID: 42318627.

This retrospective observational study compared healthcare resource use and costs between pre-emptive kidney transplantation (transplantation without prior dialysis) and maintenance dialysis using Optum’s Clinformatics Data Mart Database from January 2012 to July 2024. Among 14,135 patients with end-stage kidney disease (1,153 pre-emptive transplant, 12,982 maintenance dialysis), outcomes at 24 months were compared with weighted generalised linear modelling. Transplant recipients were far more likely to be hospitalised (OR 10.68, 95% CI 6.00–19.02) and had more hospitalisations per person (event-rate ratio 1.21), reflecting the perioperative burden, but they had fewer emergency department visits (OR 0.49) and fewer outpatient visits per person (event-rate ratio 0.30). Costs for pre-emptive transplantation were higher initially, but dialysis costs overtook them from roughly month five onward. Over 24 months, estimated total per-person costs were $303,725 for pre-emptive transplantation versus $637,134 for dialysis, a saving of $333,409 (95% CI $263,461–$403,356). The analysis is limited by its observational design and the likelihood that pre-emptively transplanted patients are systematically healthier, and the absolute dollar figures reflect the US payer system. Even so, it adds economic weight to the clinical case for pre-emptive transplantation, a priority the UK already promotes through earlier listing and living donation.

8. Trends in Survival and Unmet Need Across Solid Organ Transplantation

Burns CJ, Sangineni PV, Myres SE, Widner JA, Campioli MA, Goss JA, Rana A. J Am Coll Surg, 2026. PMID: 41925214.

This national database study used intention-to-treat (ITT) survival — which integrates waitlist survival, transplant rate, and post-transplant survival — to gauge how well the transplant system meets candidates’ needs over time. Drawing on 1,409,764 adult candidates listed in the United Network for Organ Sharing database from January 1987 to July 2024, the authors applied Kaplan-Meier estimates with log-rank tests and Cox models comparing outcomes by decade and by primary organ. Between 1988 and 2023, both one-year ITT survival and post-transplant survival improved significantly across all organ types. Kidney and lung candidates showed the most dramatic ITT survival gains, whereas post-transplant survival improved most for lung and pancreas recipients. Critically, kidney transplantation carried the highest and most persistent unmet need, with little change since the mid-2010s, while unmet need for lung and pancreas transplantation fell substantially. The authors attribute persistent kidney disparities to the gap between demand and organ availability and point to recent policy changes and emerging technologies as routes to more equitable outcomes. As a US registry analysis the specific figures are system-bound, but the structural conclusion travels: despite steady gains in survival after listing and transplantation, the access gap for kidney transplantation remains the defining challenge, reinforcing why donor-pool expansion stays central to UK strategy.

Generated 2026-06-19 from PubMed search results for kidney transplantation published 2026-06-05 to 2026-06-19. Articles already recorded in prior issues were excluded. PubMed is the source of all metadata and abstracts.