Publication Name	World Journal of Transplantation
Manuscript ID	117357
Country	Egypt

Category	Pediatrics
Manuscript Type	Review
Article Title	Immunosenescence and cancer predisposition in pediatric transplant recipients: An emerging paradigm
Manuscript Source	Invited Manuscript
All Author List	Aya Mohamed Adel Arafat, Soliman M A Soliman, Habiba Elfandy, Moamen O Othman, Walaa Elsayed, Mai M Lotfy and Noura A A Ebrahim
Funding Agency and Grant Number
Corresponding Author	Noura A A Ebrahim, Department of Oncologic Pathology, National Cancer Institute, Cairo University, 1st El Kasr El Aini Street, Cairo 11796, Egypt. npathologist@gmail.com
Key Words	Immunosenescence; Pediatric transplantation; Cancer predisposition; T cell exhaustion; Post-transplant lymphoproliferative disease; Cytomegalovirus; Telomere dysfunction; Thymic involution; Inflammaging; Senescence-associated secretory phenotype
Core Tip	Children who undergo organ transplantation often experience premature aging of the immune system, largely due to factors such as ATG exposure, CMV reactivation, thymic dysfunction, and long-term immunosuppressive therapy. This accelerated immune decline substantially increases their risk of developing cancer both early and later in life. Adopting a biomarker-driven clinical approach—including senescence-related flow cytometry panels, TREC/telomere assessments, and epigenetic aging markers—along with tailored immunosuppression strategies, vigilant CMV management, and emerging therapies targeting senescent, thymic, or metabolic pathways may help lessen cancer risk and improve long-term patient outcomes.
Citation	Arafat AMA, Soliman SMA, Elfandy H, Othman MO, Elsayed W, Lotfy MM, Ebrahim NAA. Immunosenescence and cancer predisposition in pediatric transplant recipients: An emerging paradigm. World J Transplant 2026; In press

Received	2025-12-05 00:45
Peer-Review Started	2025-12-05 00:45
First Decision by Editorial Office Director	2026-01-08 09:18
Return for Revision	2026-01-08 09:18
Revised	2026-02-09 20:51
Publication Fee Transferred
Second Decision by Editor	2026-04-02 02:34
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-02 04:02
Articles in Press	2026-04-02 04:02
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3230 (online)
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