Advancing patient monitoring, diagnostics, and treatment strategies for transplant precision medicine

Transplant medicine faces substantial challenges, as patients require lifelong immunosuppression to prevent graft rejection. Immunosuppressive regimens to date, while reasonably effective at preventing acute rejection, cause numerous health complications, compromising quality of life and patient survival. A shift towards personalised immunosuppression is needed to improve allograft health, reduce long-term adverse effects, and optimise post-transplant outcomes. This necessity has driven advancements in post-transplant monitoring and diagnostics. Innovative monitoring biomarkers and novel diagnostic modalities have been developed to advance transplant care, with many showing promise for widespread clinical implementation. With advances in artificial intelligence, algorithms have the potential to integrate multidimensional data on the immune system and allograft health, offering a comprehensive view of transplant status. This Series paper highlights the state of post-transplant immunosuppression, monitoring, and diagnostics, emphasising the transformative role of emerging innovations to personalise both allograft and patient care. Their implications could extend to xenotransplantation, further broadening their potential to redefine transplant medicine.