The Lancet launched its Clinical Series on Solid Organ Transplantation in response to rapid scientific advances that are transforming the field. Transplantation has long faced three major challenges:

1. a shortage of transplantable organs;
2. the toxicities of imprecise immunosuppression that cause patients to suffer complications including infections, cancer, and rejection of the allograft; and
3. inequities in access to transplantation and disparities in outcomes after transplantation.

Transplant scientists have a strong tradition of driving progress through interdisciplinary collaboration drawing on fields as varied as immunology, engineering, and ethics. Today, progress is accelerating.

The first paper in the Series reports on solutions to the problem of a lack of organs. These innovations include better preservation and new capabilities of repairing human deceased donor organs through next-generation perfusion pumps, as well as the creation of bioengineered pig organs for transplant.

The second Series paper describes novel tools for precision immunosuppression such as cell-free DNA that enable clinicians to customize medical regimens to the needs of individual transplant recipients. When transplanted organs suffer injury, novel techniques from molecular pathology enable clinicians to better diagnose rejection with deep phenotyping of allograft biopsies.

The final manuscript turns to health equity and proposes policy strategies to ensure that the benefits of transplantation extend to all patients with end-stage organ disease who need a transplant, both nationally and globally.