{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:32:21Z","timestamp":1787610741849,"version":"build-2736575974"},"reference-count":81,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014718","name":"Innovative Research Group Project of the National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014718","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>The success of solid organ transplantation (SOT) and the use of immunosuppressants provide patients with terminal conditions hope. Acute immune rejection (AR) in SOT patients, however, has become more noticeable. Our study examined the relationship between AR and patient survival in a variety of organ transplants, including liver, kidney, heart, lung, pancreas, intestine, combined heart\u2013lung, and pancreas\u2013kidney transplantations, using the Scientific Registry of Transplant Recipients (SRTR) database. Our research showed that AR universally reduces survival across all solid organ transplant types. Immunosuppressants exhibit organ-specific efficacy patterns, with divergent impacts on survival and AR risk. For instance, in liver transplants (LT), generic tacrolimus increased AR risk (OR: 1.31; 95% CI: 1.21\u20131.42), while AZA reduced it (OR: 0.52; 95% CI: 0.44\u20130.60). In kidney transplants (KT), tacrolimus increased AR risk (OR: 1.24; 95% CI: 1.2\u20131.28), whereas Cyclosporin reduced it (OR: 0.47; 95% CI: 0.43\u20130.52). Furthermore, the same immunosuppressant can have varying effects on survival across transplant types; MMF significantly increased the risk of death in LT, HT, LU, KT, HL, and PK patients, but reduced the risk of death in PT patients. Originator and generic immunosuppressants differentially influence survival outcomes and rejection incidence. For example, in heart transplantation (HT), originator cyclosporine improved survival, while generic cyclosporine (EON) was associated with decreased survival and increased AR risk. Overall, our research offers a thorough and methodical evaluation of how various immunosuppressants affect prognosis and how AR affects the survival of patients receiving different kinds of SOT.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1739468","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T14:09:57Z","timestamp":1769782197000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of different immunosuppressants and acute immune rejection on clinical outcomes in diverse solid organ transplant recipients"],"prefix":"10.3389","volume":"16","author":[{"given":"Zhihao","family":"Wang","sequence":"first","affiliation":[{"name":"Organ Transplantation Clinical Medical Center of Xiamen University, Department of General Surgery, Xiang\u2019an Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, China"]},{"name":"Organ Transplantation Institute of Xiamen University, Xiamen Human Organ Transplantation Quality Control Center, Xiamen Key Laboratory of Regeneration Medicine, Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Organ Transplantation Clinical Medical Center of Xiamen University, Department of General Surgery, Xiang\u2019an Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, China"]},{"name":"Organ Transplantation Institute of Xiamen University, Xiamen Human Organ Transplantation Quality Control Center, Xiamen Key Laboratory of Regeneration Medicine, Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Wu","sequence":"additional","affiliation":[{"name":"Organ Transplantation Clinical Medical Center of Xiamen University, Department of General Surgery, Xiang\u2019an Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, China"]},{"name":"Organ Transplantation Institute of Xiamen University, Xiamen Human Organ Transplantation Quality Control Center, Xiamen Key Laboratory of Regeneration Medicine, Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong","family":"Zeng","sequence":"additional","affiliation":[{"name":"Organ Transplantation Clinical Medical Center of Xiamen University, Department of General Surgery, Xiang\u2019an Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, China"]},{"name":"Organ Transplantation Institute of Xiamen University, Xiamen Human Organ Transplantation Quality Control Center, Xiamen Key Laboratory of Regeneration Medicine, Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Organ Transplantation Clinical Medical Center of Xiamen University, Department of General Surgery, Xiang\u2019an Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, China"]},{"name":"Organ Transplantation Institute of Xiamen University, Xiamen Human Organ Transplantation Quality Control Center, Xiamen Key Laboratory of Regeneration Medicine, Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziqiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Liver Transplantation and Hepatic Surgery, the First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"409","DOI":"10.21037\/atm.2018.09.68","article-title":"Solid organ transplantation in the 21(st) century","volume":"6","author":"Black","year":"2018","journal-title":"Ann Transl Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/books978-3-0365-4008-5","article-title":"Progress and recent advances in solid organ transplantation","volume":"11","author":"Thongprayoon","year":"2022","journal-title":"J Clin Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2481","article-title":"Immunosuppression trends in solid organ transplantation: The future of individualization, monitoring, and management","volume":"41","author":"Pilch","year":"2021","journal-title":"Pharmacotherapy"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000001135","article-title":"Impact of varied immunosuppressive agents and post-transplant diabetes mellitus on prognosis among diverse transplant recipients (experimental studies)","volume":"110","author":"Liu","year":"2024","journal-title":"Int J Surg"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000806","article-title":"Insights into the history and tendency of liver transplantation for liver cancer: a bibliometric-based visual analysis","volume":"110","author":"He","year":"2024","journal-title":"Int J Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1007\/978-1-4939-8938-6_12","article-title":"Diverse roles of immune cells in transplant rejection and immune tolerance","volume":"10","author":"Gan","year":"2022","journal-title":"Engineering"},{"key":"B7","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1038\/s41392-023-01377-9","article-title":"Activation of immune signals during organ transplantation","volume":"8","author":"Li","year":"2023","journal-title":"Signal Transduct Target Ther"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2017.04.001","article-title":"Overview of immunosuppressive therapy in solid organ transplantation","volume":"35","author":"Holt","year":"2017","journal-title":"Anesthesiol Clin"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.5114\/ceji.2014.45955","article-title":"Immunosuppressive therapy in allograft transplantation: from novel insights and strategies to tolerance and challenges","volume":"39","author":"Ebrahimi","year":"2014","journal-title":"Cent Eur J Immunol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2024.02.211","article-title":"Incidence and risk factors for rejection after conversion from calcineurin inhibitor to sirolimus-based immunosuppression in orthotopic heart transplant recipients","volume":"45","author":"Inglis","year":"2024","journal-title":"J Heart Lung Transplant"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1007\/s40472-021-00321-6","article-title":"Immunosuppression considerations for older kidney transplant recipients","volume":"8","author":"Cheungpasitporn","year":"2021","journal-title":"Curr Transplant Rep"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3390\/mps3040068","article-title":"KidneyCare guided immuno-optimization in renal allografts: the KIRA protocol","volume":"3","author":"Gray","year":"2020","journal-title":"Methods Protoc"},{"key":"B13","doi-asserted-by":"publisher","first-page":"12114","DOI":"10.1038\/s41598-021-91630-4","article-title":"Clinical significance of tacrolimus intra-patient variability on kidney transplant outcomes according to pre-transplant immunological risk","volume":"11","author":"Kim","year":"2021","journal-title":"Sci Rep"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-024-00870-6","article-title":"Regulatory T cell-mediated immunosuppression orchestrated by cancer: towards an immuno-genomic paradigm for precision medicine","volume":"21","author":"Kumagai","year":"2024","journal-title":"Nat Rev Clin Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s00281-011-0259-7","article-title":"Steroids in kidney transplant patients","volume":"33","author":"Steiner","year":"2011","journal-title":"Semin Immunopathol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.immuni.2025.01.008","article-title":"Identification of indirect CD4(+) T cell epitopes associated with transplant rejection provides a target for donor-specific tolerance induction","volume":"58","author":"Zhanzak","year":"2025","journal-title":"Immunity"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11","article-title":"Diagnosis and prevention of chronic kidney allograft loss","volume":"378","author":"Nankivell","year":"2011","journal-title":"Lancet"},{"key":"B18","doi-asserted-by":"publisher","first-page":"100511","DOI":"10.1016\/j.trre.2019.100511","article-title":"Medication non-adherence after kidney transplantation: A critical appraisal and systematic review","volume":"34","author":"Gokoel","year":"2020","journal-title":"Transplant Rev (Orlando)"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003764","article-title":"Kidney transplant recipients rarely show an early antibody response following the first COVID-19 vaccine administration","volume":"105","author":"Yi","year":"2021","journal-title":"Transplantation"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12590","article-title":"Banff 2013 meeting report: inclusion of c4d-negative antibody-mediated rejection and antibody-associated arterial lesions","volume":"14","author":"Haas","year":"2014","journal-title":"Am J Transplant"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2008.02159.x","article-title":"Banff 07 classification of renal allograft pathology: updates and future directions","volume":"8","author":"Solez","year":"2008","journal-title":"Am J Transplant"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14608","article-title":"Antibody-mediated rejection after kidney transplantation in children; therapy challenges and future potential treatments","volume":"36","author":"Bertacchi","year":"2022","journal-title":"Clin Transplant"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14228","article-title":"Assessment of tocilizumab (Anti-interleukin-6 receptor monoclonal) as a potential treatment for chronic antibody-mediated rejection and transplant glomerulopathy in HLA-sensitized renal allograft recipients","volume":"17","author":"Choi","year":"2017","journal-title":"Am J Transplant"},{"key":"B24","doi-asserted-by":"publisher","first-page":"201754","DOI":"10.1155\/2012\/201754","article-title":"Antibody-mediated rejection: pathogenesis, prevention, treatment, and outcomes","volume":"2012","author":"Blume","year":"2012","journal-title":"J Transplant"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506027","article-title":"Belatacept and long-term outcomes in kidney transplantation","volume":"374","author":"Vincenti","year":"2016","journal-title":"N Engl J Med"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.09.012","article-title":"Clinical features and allograft failure rates of pulmonary antibody-mediated rejection categories","volume":"42","author":"Charya","year":"2023","journal-title":"J\u00a0Heart Lung Transplant"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001409","article-title":"Delayed graft function phenotypes and 12-month kidney transplant outcomes","volume":"101","author":"Hall","year":"2017","journal-title":"Transplantation"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-6143.2003.00059.x","article-title":"Impact of acute rejection episodes on long-term graft survival following simultaneous kidney-pancreas transplantation","volume":"3","author":"Reddy","year":"2003","journal-title":"Am J Transplant"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2016.03.002","article-title":"Ex-vivo liver perfusion for organ preservation: Recent advances in the field","volume":"30","author":"Barbas","year":"2016","journal-title":"Transplant Rev (Orlando)"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1038\/s41435-021-00139-3","article-title":"Revisiting steroidogenesis and its role in immune regulation with the advanced tools and technologies","volume":"22","author":"Chakraborty","year":"2021","journal-title":"Genes Immun"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1079011","article-title":"Steroid receptor coactivators - their role in immunity","volume":"13","author":"Gilad","year":"2022","journal-title":"Front Immunol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1038\/nri.2017.1","article-title":"Immune regulation by glucocorticoids","volume":"17","author":"Cain","year":"2017","journal-title":"Nat Rev Immunol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.jsbmb.2010.03.058","article-title":"The role of the glucocorticoid receptor in inflammation and immunity","volume":"120","author":"Baschant","year":"2010","journal-title":"J Steroid Biochem Mol Biol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.5500\/wjt.v11.i11.443","article-title":"Current status of glucocorticoid usage in solid organ transplantation","volume":"11","author":"Dashti-Khavidaki","year":"2021","journal-title":"World J Transplant"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhlto.2025.100214","article-title":"Corticosteroid use beyond 1-year post heart transplantation is associated with worse outcomes: A contemporary analysis of the ISHLT registry","volume":"8","author":"Jaiswal","year":"2025","journal-title":"JHLT Open"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S332201","article-title":"Adverse effects of long-term oral corticosteroids in the department of dermatology, antananarivo, Madagascar","volume":"14","author":"Sendrasoa","year":"2021","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2024.10.013","article-title":"Impact of tacrolimus vs cyclosporine on chronic lung allograft dysfunction incidence and allograft survival in the International Society of Heart and Lung Transplantation registry","volume":"44","author":"Combs","year":"2025","journal-title":"J Heart Lung Transplant"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2024.11.012","article-title":"Development of a patient reported outcome measure of side effects for patients taking calcineurin inhibitors: the FACIT-CNI-ntx","volume":"85","author":"Hurt","year":"2025","journal-title":"Am J Kidney Dis"},{"key":"B39","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1002\/jmd2.12088","article-title":"Neurotoxicity including posterior reversible encephalopathy syndrome after initiation of calcineurin inhibitors in transplanted methylmalonic acidemia patients: Two case reports and review of the literature","volume":"51","author":"Molema","year":"2020","journal-title":"JIMD Rep"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1038\/nm.2497","article-title":"The calcineurin inhibitor tacrolimus activates the renal sodium chloride cotransporter to cause hypertension","volume":"17","author":"Hoorn","year":"2011","journal-title":"Nat Med"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.33549\/physiolres.933332","article-title":"Pathophysiological mechanisms of calcineurin inhibitor-induced nephrotoxicity and arterial hypertension","volume":"66","author":"Hoskova","year":"2017","journal-title":"Physiol Res"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1038\/s41401-018-0070-2","article-title":"Biomarkers for individualized dosage adjustments in immunosuppressive therapy using calcineurin inhibitors after organ transplantation","volume":"40","author":"Fu","year":"2019","journal-title":"Acta Pharmacol Sin"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2012.01.033","article-title":"Confronting the challenge: individualized immune monitoring after organ transplantation using the cellular immune function assay","volume":"413","author":"Israeli","year":"2012","journal-title":"Clin Chim Acta"},{"key":"B44","doi-asserted-by":"publisher","first-page":"e18636","DOI":"10.7717\/peerj.18636","article-title":"CYP3A4 and CYP3A5: the crucial roles in clinical drug metabolism and the significant implications of genetic polymorphisms","volume":"12","author":"Zhang","year":"2024","journal-title":"PeerJ"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2017.02.004","article-title":"mTOR signaling in growth, metabolism, and disease","volume":"168","author":"Saxton","year":"2017","journal-title":"Cell"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1038\/nrd3531","article-title":"Rapamycin passes the torch: a new generation of mTOR inhibitors","volume":"10","author":"Benjamin","year":"2011","journal-title":"Nat Rev Drug Discov"},{"key":"B47","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1038\/nri3901","article-title":"Regulation of innate immune cell function by mTOR","volume":"15","author":"Weichhart","year":"2015","journal-title":"Nat Rev Immunol"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1038\/nri3198","article-title":"Regulation and function of mTOR signalling in T cell fate decisions","volume":"12","author":"Chi","year":"2012","journal-title":"Nat Rev Immunol"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2014.01.001","article-title":"Rapamycin: one drug, many effects","volume":"19","author":"Li","year":"2014","journal-title":"Cell Metab"},{"key":"B50","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1186\/2047-1440-2-S1-S2","article-title":"The influence of mTOR inhibitors on immunity and the relationship to post-transplant Malignancy","volume":"2","author":"Geissler","year":"2013","journal-title":"Transplant Res"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12975","article-title":"mTOR inhibitors and risk of chronic antibody-mediated rejection after kidney transplantation: where are we now","volume":"30","author":"Grimbert","year":"2017","journal-title":"Transpl Int"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16748","article-title":"Targeting peripheral\u00a0immune organs with self-assembling prodrug nanoparticles ameliorates allogeneic heart transplant rejection","volume":"21","author":"Zhou","year":"2021","journal-title":"Am J Transplant"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.5500\/wjt.v6.i1.183","article-title":"Immunosuppressive potency of mechanistic target of rapamycin inhibitors in solid-organ transplantation","volume":"6","author":"Baroja-Mazo","year":"2016","journal-title":"World J Transplant"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-019-00810-9","article-title":"Sirolimus and mTOR inhibitors: A review of side effects and specific management in solid organ transplantation","volume":"42","author":"Nguyen","year":"2019","journal-title":"Drug Saf"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000759","article-title":"Maintaining the optimum level of immunosuppressive agents minimizes risk of liver allograft fibrosis during pediatric liver transplantation","volume":"110","author":"Tedla","year":"2024","journal-title":"Int J Surg"},{"key":"B56","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1097\/TP.0000000000001447","article-title":"Cancer and mTOR inhibitors in transplant recipients","volume":"101","author":"de Fijter","year":"2017","journal-title":"Transplantation"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14228","article-title":"Mtor inhibitors associated with higher cardiovascular adverse events-A large population database analysis","volume":"35","author":"Nguyen","year":"2021","journal-title":"Clin Transplant"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2014.03.002","article-title":"Strategies for the management of adverse events associated with mTOR inhibitors","volume":"28","author":"Kaplan","year":"2014","journal-title":"Transplant Rev (Orlando)"},{"key":"B59","doi-asserted-by":"publisher","first-page":"112820","DOI":"10.1016\/j.ejmech.2020.112820","article-title":"Research progress of mTOR inhibitors","volume":"208","author":"Chen","year":"2020","journal-title":"Eur J Med Chem"},{"key":"B60","first-page":"31","article-title":"Functional consequences of mTOR inhibition","volume":"13","author":"Sudarsanam","year":"2010","journal-title":"Curr Opin Drug Discov Devel"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2016.00387","article-title":"Oncological impact of M-tor inhibitor immunosuppressive therapy after liver transplantation for hepatocellular carcinoma: review of the literature","volume":"7","author":"Tarantino","year":"2016","journal-title":"Front Pharmacol"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12372","article-title":"Mammalian target of rapamycin inhibitors are associated with lower rates of hepatocellular carcinoma recurrence after liver transplantation: a systematic review","volume":"27","author":"Cholongitas","year":"2014","journal-title":"Transpl Int"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12185","article-title":"Meta-analysis: recurrence and survival following the use of sirolimus in liver transplantation for hepatocellular carcinoma","volume":"37","author":"Menon","year":"2013","journal-title":"Aliment Pharmacol Ther"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30060421","article-title":"The Role of mTOR Inhibitors after Liver Transplantation for Hepatocellular Carcinoma","volume":"30","author":"Todeschini","year":"2023","journal-title":"Curr Oncol"},{"key":"B65","doi-asserted-by":"publisher","first-page":"h3163","DOI":"10.1136\/bmj.h3163","article-title":"Generic immunosuppression in solid organ transplantation: systematic review and meta-analysis","volume":"350","author":"Molnar","year":"2015","journal-title":"BMJ"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1159\/000449020","article-title":"Bioavailability, efficacy and safety of generic immunosuppressive drugs for kidney transplantation: A systematic review and meta-analysis","volume":"44","author":"Tsipotis","year":"2016","journal-title":"Am J Nephrol"},{"key":"B67","article-title":"LiverTox: Clinical and Research Information on Drug-Induced Liver Injury","year":"2012","journal-title":"Bethesda (MD)"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000435701.54019.98","article-title":"A comparison of outcomes between OKT3 and antithymocyte globulin for treatment of steroid-resistant rejection in hepatitis C liver transplant recipients","volume":"97","author":"Benjamin","year":"2014","journal-title":"Transplantation"},{"key":"B69","article-title":"Mechanisms of immunosuppression induced by antithymocyte globulins and OKT3","volume":"15","author":"Bonnefoy-Berard","year":"1996","journal-title":"J Heart Lung Transplant"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1038\/nrd3877","article-title":"Advances in targeting cell surface signalling molecules for immune modulation","volume":"12","author":"Yao","year":"2013","journal-title":"Nat Rev Drug Discov"},{"key":"B71","doi-asserted-by":"publisher","first-page":"CD008927","DOI":"10.1002\/14651858.CD008927.pub2","article-title":"Antibody induction therapy for lung transplant recipients","volume":"2013","author":"Penninga","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15475","article-title":"A path toward improving health literacy and transplant outcomes","volume":"19","author":"Pullen","year":"2019","journal-title":"Am J Transplant"},{"key":"B73","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2012.08.001","article-title":"Evaluation of adherence to immunosuppressive drugs in kidney transplantation by control of medication dispensing","volume":"44","author":"Brahm","year":"2012","journal-title":"Transplant Proc"},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.03138","article-title":"Cyclophosphamide-induced tolerance in allogeneic transplantation: from basic studies to clinical application","volume":"10","author":"Kato","year":"2019","journal-title":"Front Immunol"},{"key":"B75","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/S0966-3274(00)00013-7","article-title":"Allograft tolerance induced by cyclophosphamide without prior inoculation of donor cells--immune suppression and redirection","volume":"8","author":"Gao","year":"2000","journal-title":"Transpl Immunol"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.744430","article-title":"A review of cyclophosphamide-induced transplantation tolerance in mice and its relationship with the HLA-haploidentical bone marrow transplantation\/post-transplantation cyclophosphamide platform","volume":"12","author":"Mayumi","year":"2021","journal-title":"Front Immunol"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.636789","article-title":"Use of post-transplant cyclophosphamide treatment to build a tolerance platform to prevent liquid and solid organ allograft rejection","volume":"12","author":"Lightbourn","year":"2021","journal-title":"Front Immunol"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.96378","article-title":"Selective CD28 blockade attenuates CTLA-4-dependent CD8+ memory T cell effector function and prolongs graft survival","volume":"3","author":"Liu","year":"2018","journal-title":"JCI Insight"},{"key":"B79","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-013-0153-2","article-title":"Pharmacokinetics,\u00a0pharmacodynamics, and immunogenicity of belatacept in adult kidney transplant recipients","volume":"34","author":"Shen","year":"2014","journal-title":"Clin Drug Investig"},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00028-0","article-title":"Comparative effectiveness of azathioprine and mycophenolate mofetil for myasthenia gravis (PROMISE-MG): a prospective cohort study","volume":"23","author":"Narayanaswami","year":"2024","journal-title":"Lancet Neurol"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.220620","article-title":"Severity of COVID-19 among solid organ transplant recipients in Canada, 2020-2021: a prospective, multicentre cohort study","volume":"194","author":"Hall","year":"2022","journal-title":"CMAJ"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1739468\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T14:09:59Z","timestamp":1769782199000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1739468\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":81,"alternative-id":["10.3389\/fimmu.2025.1739468"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1739468","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,30]]},"article-number":"1739468"}}