The only effective treatment for patients with end-stage organ disease is organ transplantation. Although tremendous progress has been made in organ transplantation procedures, organ preservation techniques, and new immunosuppressive agents, there still exists a significant gap between the availability of organs and clinical demand. The shortage of donors has become a serious social problem that limits the growth of organ transplantation worldwide. In clinical practice, organs are mainly sourced from deceased individuals, living donors, or donations after brain death.

Additionally, various injuries associated with transplanted organs such as immune rejection injuries and ischemia-reperfusion injuries are major factors contributing to graft dysfunction or failure. It is crucial to identify molecules that can predict graft injury, explore mechanisms underlying graft organ injury, and discover molecules for treating such injuries in order to reduce graft damage further, expand the donor pool, and improve transplant patient prognosis.

Ischemia-reperfusion injury of transplanted organs includes direct injury caused by ischemia and delayed injury caused by inflammation. Injury to the cells of transplanted solid organs is a key step in mediating this process, as it induces infiltration of immune cells such as macrophages, neutrophils, and lymphocytes, and the release of various inflammatory cytokines that exacerbate organ injury. However, the mechanism underlying cell injury in transplanted solid organs and its interaction with immune cells in the microenvironment are still unclear, while effective methods for diagnosing and treating ischemia-reperfusion injury are lacking. Rejection of transplanted organs is primarily attributed to donor-specific antibodies against human leukocyte antigens (HLA) on the graft's endothelium. Researchers still have an incomplete understanding of the causes and mechanisms of rejection and lack effective therapies to prevent antibody-mediated rejection.

The complicated damaging mechanism of transplanted organs mentioned above renders singular factors slightly powerless in the assessment and treatment of damage after organ transplantation.

However, the emergence of a multi-omics approach for this dilemma opens up new horizons. Based on RNA transcriptome sequencing, proteomics, metabolomics, and extracellular secretion profiling, combined with increasingly mature computational methods, researchers can determine the damage to transplanted organs, reveal the molecular mechanism of organ damage, and provide multi molecular targeted interventions for damaged transplanted organs. This may offer a new strategy to reduce organ transplant damage and improve the prognosis of transplant patients.

In this Research Topic, our main objectives are to reveal the molecules involved in diagnosing and assessing transplant organ damage by utilizing multi-omics assays and computer-assisted techniques. Based on these findings, we aim to clarify the network of multimolecular mechanisms that exacerbate transplant organ damage and propose novel multidimensional therapeutic regimens.

We invite original research, review articles, and opinion pieces focusing on various topics in the field of solid organ transplantation including but not limited to:

• Application of multi-omics technologies such as RNA transcriptome sequencing, proteomics, metabolomics, single-cell transcriptome analysis, and exocrine profiling for diagnosing organ transplantation injuries and targeted therapies.

• Development of predictive models using computer-assisted technology to integrate multi-omics data for assessing transplant organ damage and determining appropriate adjuvant medications.

• Evaluation of the efficacy and side effects of currently clinically used drugs for anti-transplant organ damage based on large-scale clinical data from multiple organ transplantation diseases.

• Development of new therapeutic drugs including cell-based therapies, natural small molecule drugs, RNA-based therapeutics etc., in the field of solid organ transplantation.

• Applications of materials science in preventing transplant organ damage as well as improving drug safety, biocompatibility, and targeting properties.

The Topic Editors declare no conflict of interest with regards to this Research Topic.

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Frontiers in Immunology

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