Nanotechnology in Transplantation: Emerging Mechanisms, Clinical Applications, and Future Directions

Nanotechnology has rapidly evolved into a transformative platform in transplant medicine, offering sophisticated tools for targeted drug delivery, organ preservation, precision diagnostics, and tolerance induction. Engineered nanoparticles enable localized and sustained delivery of immunosuppressive agents while minimizing systemic toxicity, thus allowing long-standing limitations of conventional immunosuppression to be addressed. Diverse nanomedicine platforms, including liposomes, polymeric nanoparticles, dendrimers, magnetic nanoparticles, and inorganic systems, enhance drug bioavailability, reduce off-target effects, and allow integration of imaging and therapeutic functions. This review synthesized current progress in nanoparticle-enabled therapeutics, diagnostics, machine-perfusion-based delivery, gene editing, and personalized nano-immunotherapy, highlighting their potential to reduce rejection, ischemia-reperfusion injury, and chronic graft dysfunction. Insights from recent advances.