Medical practice in kidney transplantation is advancing toward innovative approaches that optimize pharmacological safety, immunosuppressive management, and the prevention of post-transplant complications. This Special Issue compiles studies on the efficacy of finerenone in kidney transplant recipients, selection patterns for kidney transplantation versus dialysis in lung recipients with end-stage renal disease, post-transplant glomerulonephritis recurrence, long-term outcomes in living donors with multiple renal arteries, clinical factors influencing tacrolimus metabolism and formulation comparisons, the use of Torque Teno virus as a marker of net immunosuppression, compatibility of immunosuppressive therapies with lactation, and the superiority of LCPT tacrolimus in preventing post-transplant diabetes in high-risk patients.
These works highlight advances in non-invasive biomarkers, optimization of immunosuppressants such as extended-release tacrolimus, and strategies to mitigate risks like glomerular recurrence, post-transplant diabetes, and over-immunosuppression. The focus on prospective cohorts and narrative reviews underscores the importance of personalizing treatment to improve graft survival and long-term clinical outcomes in complex populations, including living donors and patients with comorbidities. This Reprint collects key evidence to guide clinical decisions in transplant nephrology.