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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Mar 18, 2026; 16(1): 112811
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.112811
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.112811
Pathogenic analysis of post-transplantation obesity: A comprehensive systematic review
Ke-Ran Chen, Lin-Zhi Wu, Yi-Ning Huang, Si-Yu Zhuang, Ze-Yu Chen, Bin Xu, Tian-Cheng Xu, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
Co-first authors: Ke-Ran Chen and Lin-Zhi Wu.
Co-corresponding authors: Bin Xu and Tian-Cheng Xu.
Author contributions: Chen KR and Xu TC conceived and designed the outline; Chen KR, Wu LZ, Huang YN, Zhuang SY, and Chen ZY wrote the paper and searched the literature focusing on macrophage-mediated metabolic dysregulation of the pancreas; Chen KR was responsible for the main writing and made an indispensable and important contribution to the completion of the manuscript, and therefore is eligible to be the first author of this paper; as a co-corresponding author, Xu TC and Xu B played an integral and important role in the interpretation of the data and preparation of the manuscript; all authors participated in the initial writing and read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 82305376; the Youth Talent Support Project of the China Acupuncture and Moxibustion Association, No. 2024-2026ZGZJXH-QNRC005; the 2024 Jiangsu Province Youth Science and Technology Talent Support Project, No. JSTJ-2024-380; 2025 Jiangsu Provincial Science and Technology Think Tank Program Project, No. JSKX0125035; and 2025 College Student Innovation Training Program Project, No. X202510315373.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest associated with the publication of this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Tian-Cheng Xu, MD, PhD, Professor, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Qixia District, Nanjing 210023, Jiangsu Province, China.
Received: August 7, 2025
Revised: August 20, 2025
Accepted: December 2, 2025
Published online: March 18, 2026
Processing time: 161 Days and 4.3 Hours
Revised: August 20, 2025
Accepted: December 2, 2025
Published online: March 18, 2026
Processing time: 161 Days and 4.3 Hours
Core Tip
Core Tip: Organ transplantation for end-stage failure faces post-transplant obesity, a key challenge. This review analyzes its multifactorial causes: Immunosuppressants (corticosteroids, calcineurin inhibitors) disrupt metabolism, hypoactivity worsens energy imbalance, poor diet promotes weight gain, and molecularly, immunosuppressants affect adipokines and insulin, with inflammation driving lipid accumulation. It offers a framework for mitigation strategies.