Mark D. Stegall, M.D., has led a funded research program for nearly 35 years. Dr. Stegall focuses his research on transplant immunology and artificial intelligence (AI).
Dr. Stegall's major research goals are to:
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Kidney transplant recipients who are older. The kidney transplant population is aging. In 2000, only 8% of the kidney transplant population was greater than 65 years of age at the time of transplant. In 2025, this number was 26%.
A concern facing older kidney transplant recipients is not graft loss but rather mortality. This is primarily due to infection, cancer and other conditions of aging. A major contributor to this mortality is a declining immune system due to immunosuppression after kidney transplantation.
Dr. Stegall's laboratory-based research focuses on how alterations in homeostatic proliferation and T memory stem cells contribute to the decline in immune function in older transplant recipients. Related studies examine how systemic inflammation affects patient survival.
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Immune tolerance. Kidney transplant recipients require lifelong immunosuppression to prevent rejection; however, these medicines can cause cancer, infection and heart disease. They are also often poorly tolerated.
Dr. Stegall's group develops new protocols that allow kidney transplant recipients to avoid long-term immunosuppression, or immune tolerance. The team successfully achieved immune tolerance and immunosuppression-free graft survival in several patients who were well matched to their living donors. Dr. Stegall's team is now studying tolerance protocols for living donors and recipients who are less well-matched and for those who received kidneys from deceased donors.
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AI-based automated scoring of renal transplant biopsies. The mechanisms of renal allograft loss remain unclear. Dr. Stegall's group maintains one of the largest kidney transplant biopsy datasets in the world. This includes more than 50,000 surveillance and for-cause biopsies, all of which have been digitally scanned.
Dr. Stegall's group and collaborators have developed new AI-based automated scoring algorithms using both supervised and unsupervised models. This research uses these AI approaches to more accurately assess pathological changes in the kidney after transplantation. A major focus of Dr. Stegall's work is to better understand the mechanisms of fibrosis, inflammation and graft failure using longitudinal studies.
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Kidney transplant database and biorepository. Dr. Stegall has a large research group that manages a transplant database and biorepository on almost 10,000 kidney transplant recipients at Mayo Clinic sites in Arizona, Florida and Minnesota. The biorepository includes allograft biopsies, peripheral blood, serum and urine. This comprehensive dataset and biorepository, combined with expertise in statistical analysis and laboratory infrastructure, enables Dr. Stegall's group to address research questions in kidney transplant recipients that may be beyond the ability of other groups.
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Clinical research consortium. Dr. Stegall leads a clinical research consortium involving Mayo Clinic kidney transplant programs. Collectively, Mayo Clinic performs more than 1,000 kidney transplants each year, with approximately 1 in 25 patients in the U.S. receiving a transplant at a Mayo Clinic location.
Over the past decade, the consortium has enrolled nearly 2,000 patients in multicenter clinical trials. The consortium is conducting a multicenter clinical trial to determine if minimizing immunosuppression in older kidney transplant recipients can improve survival.
Dr. Stegall's advanced research studies aim to improve the lives of patients who have received kidney transplants. The overall goal of his work is to find new ways to improve outcomes for this patient group.
Clinical trials test new treatments that could be available to patients in the near future. Dr. Stegall's laboratory work, including research using AI tools, focuses on addressing major unmet needs and developing new treatments that could help patients in the years ahead.