Transplantation in Transition: Two Decades of Evolution, Disruption, and Redefinition

This is the authors' abstract. We don't add key points for this paper.

While advances in immunosuppression are stagnating, solid organ transplantation has experienced substantial growth over the past two decades, including changes in donor and recipient epidemiology, the establishment of donation after cardiocirculatory death, expanded use of ex-situ and ex vivo machine perfusion, and the adoption of robotic techniques for living donor organ procurement and graft implantation. These advances are changing the practice of organ procurement and transplantation, but they also present new challenges. Healthcare professionals, patients, caregivers, and healthcare organizations are encouraged to adapt to these changes by modifying their work methods, mindsets, and habits accordingly. A public discussion on the sustainability of modern transplant medicine, access to transplant care for socially disadvantaged patients, training the future workforce, expanding the benefits of transplantation beyond the traditional concept of utility, and addressing the ethical dilemmas associated with caring for increasingly complex patients is encouraged at both national and international levels.