Kidney transplantation is moving into a new phase of clinical and operational change, according to transplant nephrologist Roslyn Mannon, who says innovation in therapies and organ allocation will shape the sector over the next decade.
Mannon, professor of internal medicine and research leader at University of Nebraska Medical Center, recently received the Excellence in Kidney Transplantation Award at the National Kidney Foundation Spring Clinical Meetings. Her work has focused on kidney graft outcomes, biomarkers and transplant therapies across a career spanning several decades.
She said her interest in transplantation began during medical school at Duke University after meeting a patient who described how a kidney transplant transformed his quality of life following years on dialysis. That experience led her into transplant medicine and later into clinical research.
A major turning point came when Mannon joined the National Institutes of Health in the early 2000s to help develop transplant programmes involving kidney, pancreas and islet procedures. The move expanded her work in clinical trials and translational research, particularly around graft failure and the long-term durability of transplanted kidneys.
Mannon said the development of new immunosuppressive therapies remains one of the sector’s key challenges. She noted that transplant clinicians relied on many of the same drugs for years, increasing pressure to attract greater pharmaceutical investment and expand treatment options for patients.
She also pointed to several developments that have changed the field during her career, including ex vivo organ perfusion, the use of hepatitis C-positive donor organs and the emergence of clinical xenotransplantation. Advances in hepatitis C treatment have allowed transplant centres to use organs that would previously have been considered unsuitable, helping to increase donor availability.
Looking ahead, Mannon believes reform of the Organ Procurement and Transplantation Network could become one of the most important developments for the sector. The system, which was modernised under legislation passed in 2023, is managing sharply higher transplant volumes than when it was first established nearly 40 years ago.
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