Emmanouilidou A, Avramidou E, Karageorgos FF, Anastasopoulos NA, Papalois V, Tsoulfas G. Green transplant: A scoping review of sustainability challenges and opportunities in transplantation. World J Transplant 2026; 16(1): 108837 [DOI: 10.5500/wjt.v16.i1.108837]
Corresponding Author of This Article
Angeliki Emmanouilidou, Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, Aristotle University School of Medicine, 49 Konstantinoupoleos Street, Thessaloniki 54642, Greece. emmaange@auth.gr
Research Domain of This Article
Public, Environmental & Occupational Health
Article-Type of This Article
Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 18, 2026 (publication date) through Jan 14, 2026
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Journal Information of This Article
Publication Name
World Journal of Transplantation
ISSN
2220-3230
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Emmanouilidou A, Avramidou E, Karageorgos FF, Anastasopoulos NA, Papalois V, Tsoulfas G. Green transplant: A scoping review of sustainability challenges and opportunities in transplantation. World J Transplant 2026; 16(1): 108837 [DOI: 10.5500/wjt.v16.i1.108837]
Angeliki Emmanouilidou, Eleni Avramidou, Filippos F Karageorgos, Georgios Tsoulfas, Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, Aristotle University School of Medicine, Thessaloniki 54642, Greece
Nikolaos-Andreas Anastasopoulos, Vassilios Papalois, Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom
Vassilios Papalois, Department of Surgery and Cancer, Imperial College London, London SW72AZ, United Kingdom
Author contributions: Emmanoulidou A and Tsoulfas G conceptualized the study; Emmanouilidou A, Avramidou E, Karageorgos FF, Anastasopoulos NA and Tsoulfas G contributed to the resources; Emmanouilidou A contributed to the data curation; Emmanouilidou A wrote the original draft; Emmanouilidou A, Avramidou E, Karageorgos FF, Anastasopoulos NA and Tsoulfas G wrote the review and edited the manuscript; Vassilios Papalois and Tsoulfas G supervised the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Angeliki Emmanouilidou, Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, Aristotle University School of Medicine, 49 Konstantinoupoleos Street, Thessaloniki 54642, Greece. emmaange@auth.gr
Received: April 24, 2025 Revised: June 2, 2025 Accepted: October 10, 2025 Published online: March 18, 2026 Processing time: 265 Days and 13.7 Hours
Abstract
Green transplant refers to the realization of the importance of understanding and improving the environmental footprint of transplantation through sustainable practices. This involves assessing the entire transplantation process including preoperative evaluation, donation, organ and patient transportation, surgery, postoperative recovery, and follow-up. This is a topic that has not been fully addressed yet, but its importance is being increasingly appreciated in surgery. The aim of this study was to investigate the carbon footprint associated with transplantation and propose sustainable mitigating solutions. A comprehensive review of the existing literature on transplantation was conducted and supplemented with findings from the broader fields of surgical and perioperative care, given the scarcity of available data. The analysis identified the most involved environmental factors and attempted to offer practical solutions based on current sustainability practices. Notably, no study has yet examined the carbon footprint associated with the entire transplantation procedure. Only five studies have attempted to assess the environmental impact of kidney or liver transplants, but they focused, almost explicitly, on specific steps of the process. By employing an extrapolative methodology from the broader surgical field, we determined that the primary contributors to the environmental impact of transplantation are energy, consumables and materials, anesthesia and pharmaceuticals, transportation, and water. This review offers practical solutions utilizing the 5R framework, emphasizing sustainability to ensure transplantation remains clinically and environmentally relevant.
Core Tip: Green transplantation focuses on the concept of integrating sustainable practices throughout every stage of the procedure. To ensure that transplantation remains relevant in the future, it must align with eco-friendly practices that aim to reduce greenhouse gas emissions while maintaining a high standard of patient care. This topic is not well-documented, and here, we attempt to assemble the relevant literature and offer suggestions on how to achieve this ambitious yet necessary goal.
