Subcutaneous transplantation of islets into small-pore macroencapsulation devices that prevent immune cell passage can inhibit allorejection in rodents. However, there are no reports of euglycemia in humans using this technology. This report further develops these macroencapsulation devices. We compared the ability of macroencapsulation transplant devices containing transformed mouse islet cells (MIN-6) with varying polymer membranes, pore sizes, and hydrophilicity to inhibit allorejection and maintain glycemic control in diabetic mice. We found that 10 μm pore planar polytetrafluoroethylene (PTFE) devices do not inhibit allorejection; 1-2 μm pore devices allow only partial protection; and 0.4 μm devices prevent long-term allorejection. A more hydrophilic PTFE membrane (PTFE-HP) improves device function. Devices constructed with nylon and, secondly, PTFE-HP membranes serve as transplant devices better than those constructed with polyvinylidene fluoride (PVDF), fluorinated ethylene propylene (FEP), ethylenetetrafluoroethylene (ETFE), or polyethersulfone (PES), and result in a lower fibrotic response. Allo-presensitized mice are equally protected from allorejection with 0.4 μm pore PTFE-HP transplant devices as non-presensitized mice. Our layered membrane macroencapsulation device is as effective as a single planar device in inhibiting allorejection. Nylon and, secondly, hydrophilic PTFE macroencapsulation transplant devices with 0.4 μm pores robustly prevent allotransplant rejection compared with all membranes tested and induce the least fibrosis. Future studies with nylon membranes are warranted. A multilayered device is described that reduces the skin surface requirement and increases potential islet load. A transplant model using MIN-6 cells is feasible for studying such devices to prevent allorejection.

Transplanting islets into the subcutaneous (SC) space rather than the portal vein is advantageous because this site is easier and safer to use. However, transplantation of islets directly or within planar devices has been unsuccessful in humans, mainly because of the low oxygen torr in the SC space. Since human islets are very different from mouse islets, the use of human islets in animal experiments to study SC islet transplantation may help to alleviate the roadblocks of this approach in humans. This is the first report that explores methods for SC transplantation of human islets in mice. <em>In vitro</em> studies showed that Matrigel and Geltrex serve well as islet cell matrices, whereas none of the Cytodex formulations were useful. Doses of FGF2 as high as 10,000 ng/ml were not toxic to human islets <em>in vitro</em> and could be used <em>in vivo</em>. Human islets are more viable in macroencapsulation devices than on standard culture plates. <em>In vivo</em> studies demonstrated that transplanting human islets SC into diabetic nude mice does not lower blood glucose, and administering FGF2 at the site two weeks before transplantation results in only a minimal decrease in blood glucose. SC transplantation of islets within a silicone scaffold reduced blood glucose to below 150 mg/dl by day 14, effectively normalizing blood glucose in all diabetic nude mice, whereas control mice showed no decline. Mean blood glucose remained lower than in control mice from day 6 through the end of the experiment (p < 0.05). Preimplantation of the scaffold with FGF2 augments the early decline in blood glucose. Using a 0.4 µm pore immunoprotective PTFE macroencapsulating device, FGF administration was crucial for any lowering of blood glucose in transplanted mice. The maximally effective decline in blood glucose occurred when FGF2 was preimplanted within and outside the device. This results in 100% of transplanted FGF-treated mice achieving euglycemia, while no decline in blood glucose levels occurred in control animals. When islets were transplanted SC into a 10 µm macroencapsulation device suitable for local immunotherapy, blood glucose normalized quickly in all mice and remained euglycemic for more than 9 months, whereas no control mice developed euglycemia. The aforementioned approaches of utilizing scaffolds and devices are promising for successfully studying and developing SC transplantation of human islets.

Antibody mediated rejection (AMR) is a considerable cause of late allograft failure in solid organ transplantation. Conventional approaches, using plasmapheresis, intravenous immunoglobulin, rituximab, bortezomib, and eculizumab have been unsuccessful in improving graft survival. This review aims to assess emerging therapies for AMR treatment across all organs. Using a PubMed search, literature published up to July 20, 2025 regarding tocilizumab, clazakizumab, carfilzomib, daratumumab, imlifidase, felzartamab, and obinutuzumab were reviewed. Articles were included if available in English, full-text, and reported clinical efficacy outcomes, and excluded if they discussed non-AMR indications or were review articles, single case reports, opinion pieces, protocols, animal studies, or <em>in vitro </em>studies. A total of 28 studies were included, and grouped by drug, organ, and indication. Quality was rated with the Newcastle-Ottawa Scale. The majority of evidence was with single-center retrospective studies and kidney transplantation. Tocilizumab demonstrated the most promise for stabilizing graft function in kidney chronic active AMR (cAMR). Clazakizumab failed to meet its primary efficacy outcome in its cAMR phase III study despite encouraging findings in earlier trials. Carfilzomib may be considered in acute AMR when toxicities preclude use of bortezomib, but comes with risks of nephrotoxicity. Evidence to support daratumumab’s utility in acute AMR is limited to highly heterogenous case series. Imlifidase, felzartamab, and obinutuzumab are not widely studied but may be potential therapies in the future. Studies comparing these therapies to standard of care are needed to establish the place in therapy of these agents. Additionally, there is a need to identify patient characteristics most predictive of clinical success.

Dietary guidelines and Nutrient Reference Intakes are important tools for maintaining optimal health in the general population. Similar guidelines have also been developed by specific organ health associations to help their patient populations recover from disorders or prevent/delay clinical events and subsequent complications. However, there are no specific national and international guidelines to provide dietary and nutrient intake recommendations peri-transplantation. The complex nature of transplantation and insufficient high-quality data are among the factors limiting the establishment of such dietary and nutritional guidelines. Therefore, individualized nutritional care seems to be the best strategy peri-transplantation. In this regard, strong cooperation of involved partners, including the patients and their family members/caregivers plus their healthcare providers, along with nutrition knowledge, plays a crucial role. The ultimate goal is to take advantage of the provision of adequate high-quality nutrients to facilitate a faster wound healing process and recovery from surgical procedures, prevent acute infection post-transplantation, reduce the length of hospitalization, and prevent/postpone the onset of post-transplantation metabolic morbidities. Altogether, an optimal nutritional status will help to reduce the complications associated with transplantation and relevant therapies, enhancing survival rates of donor organs. Special considerations should be given to possible interactions between dietary agents and drugs to ensure minimal damages to the “gift-of-life” and maximal rates of a long-term survival.

The increasing demand for organ transplantation has necessitated innovative strategies to maximize donor organ utilization, especially in donation after circulatory death (DCD) contexts. This article explores the integration of direct lung recovery with abdominal normothermic regional perfusion (A-NRP) to optimize organ preservation and expand the donor pool. A-NRP effectively mitigates warm ischemic injury, supporting the viability of both abdominal and thoracic organs. Our approach emphasizes meticulous surgical planning, efficient bleeding control, and seamless multidisciplinary collaboration to ensure procedure success. By combining A-NRP with state-of-the-art techniques for lung assessment and preservation, we highlight a promising pathway for enhancing graft quality and outcomes. The article discusses key logistical and ethical considerations, emphasizing the need for standardization and cooperative frameworks across transplant centers. This integrated methodology not only addresses current challenges but also sets the stage for future advancements in DCD organ transplantation, ultimately aiming to increase success rates and save more lives.

To address the pressing shortage of donor lungs, Donation after Circulatory Death (DCD) transplantation has become a vital strategy for expanding the donor pool. Minimizing warm ischemic injury is crucial for optimizing organ viability and function. This review synthesizes current evidence on Normothermic Regional Perfusion (NRP) and <em>Ex-Vivo</em> Lung Perfusion (EVLP) in DCD lung transplantation. Analysis reveals their growing efficacy in minimizing ischemic damage, facilitating organ assessment, and expanding the transplantable organ pool. Studies indicate comparable or improved recipient outcomes, including reduce primary graft dysfunction (PGD) and improved survival. However, challenges persist regarding protocol standardization, ethical considerations and long term outcome validation.

The editors of <em>OBM Transplantation </em>would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2025. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal's editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers can download a certificate of recognition directly from our submission system. Additionally, reviewers can sign up to the Web of Science Reviewer Recognition Service (formerly Publons) (<a href="https://webofscience.com/wos/">https://webofscience.com/wos/</a>) to receive recognition. Of course, in these initiatives we are careful not to compromise reviewer confidentiality. Many reviewers see their work as a voluntary and often unseen part of their role as researchers. We are grateful for the time reviewers donate to our journals and the contribution they make.

OBM Transplantation is an international peer-reviewed Open Access journal, which covers all evidence-based scientific studies related to transplantation, including: transplantation procedures and the maintenance of transplanted tissues or organs; assimilation of grafted tissue and the reconstitution of removed organs or parts of organs;

Bone grafting remains a cornerstone technique in orthopedic and reconstructive surgery, yet achieving successful graft integration continues to pose significant challenges, particularly in conditions such as osteoporosis, diabetes mellitus, and large bone defects. Traditional graft materials such as autografts, allografts, xenografts, and synthetics, often encounter limitations including immune rejection, poor vascularization, and insufficient osteogenic support. Emerging pharmacological strategies have shown promise in enhancing graft integration by modulating bone-healing pathways, promoting angiogenesis, and regulating inflammatory responses. This review comprehensively explores the biological mechanisms underlying bone repair, including the roles of key molecular pathways such as Wnt/β-catenin, BMP signaling, VEGF-mediated angiogenesis, and the RANK/RANKL/OPG axis. It further examines the therapeutic application of osteoinductive agents (e.g., BMPs, PTH analogs), anti-resorptive drugs (e.g., bisphosphonates, Denosumab), angiogenic modulators (e.g., VEGF, PDGF), and biologics targeting inflammatory cytokines (e.g., TNF-α, IL-6, IL-1β). Innovative approaches such as nanotechnology-based drug delivery, scaffold-based release systems, and gene therapy are also discussed for their potential to achieve localized, controlled, and sustained enhancement of graft performance. While several FDA-approved agents, such as rhBMP-2 and PDGF-BB, have advanced clinical practice, persistent challenges including variability in patient healing, delivery limitations, adverse effects, and regulatory hurdles, highlight the need for continued research. Future directions emphasize the development of multifunctional, personalized therapeutics that actively guide bone regeneration, supported by rigorous translational studies to ensure clinical efficacy and safety.