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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): 113633
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.113633
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.113633
Nail abnormalities in upper extremity transplantation: Perspectives and insights from systemic diseases and organ transplantation
Naga Anvesh Kodali, Ramu Janarthanan, Zeynep Demir, Bedreddin Sazoglu, Omer Faruk Dirican, Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27101, United States
Ramu Janarthanan, Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682 041, Kerala, India
Dmitry Tuder, San Antonio Military Medical Center, Uniformed Services University of The Health Sciences, San Antonio, TX 78234, United States
Fatih Zor, Department of Plastic and Reconstructive Surgery, Indiana University, Indianapolis, IN 46202, United States
Yalcin Kulahci, Vijay S Gorantla, Department of Surgery, Advocate Health, Wake Forest Uni
Author contributions: Kodali NA was responsible for conceptualization, literature search, data curation, formal analysis, writing original draft, and visualization; Janarthanan R was responsible for methodology, oversight of data extraction and tables, clinical input, writing review and editing; Demir Z was responsible for investigation, visualization, writing review and editing; Sazoglu B was responsible for resources, critical revision, writing review and editing; Dirican OF was responsible for methodology, project coordination, and critical revision; Tuder D was responsible for interpretation, clinical input, writing review and editing; Zor F was responsible for clinical oversight, senior supervision, writing review and editing; Kulahci Y was responsible for project administration, senior supervision, writing review and editing; Gorantla VS was responsible for conceptualization, senior supervision, clinical input, critical revision of the manuscript; all authors approved the final manuscript and agreed to be accountable for all aspects of the work.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
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: Yalcin Kulahci, MD, Assistant Professor, Department of Surgery, Advocate Health, Wake Forest University School of Medicine, 391 Technology Way NE, Winston-Salem, NC 27101, United States. yalcin.kulahci@advocatehealth.org
Received: August 31, 2025
Revised: October 6, 2025
Accepted: November 18, 2025
Published online: March 18, 2026
Processing time: 137 Days and 15.9 Hours
Revised: October 6, 2025
Accepted: November 18, 2025
Published online: March 18, 2026
Processing time: 137 Days and 15.9 Hours
Core Tip
Core Tip: Nail changes after upper extremity transplantation (UET) are often overlooked but may represent early and atypical signs of graft rejection. This review synthesizes evidence from vascularized composite allotransplantation, systemic diseases, and solid organ transplantation, highlighting the diagnostic and prognostic value of nail abnormalities. By recognizing patterns such as onychomadesis, dystrophy, and nailfold capillary changes, clinicians can improve surveillance and timely intervention, ultimately enhancing long-term outcomes in UET recipients.