The June issue of Transplantation Direct is available online. The issue starts out with a review on the impact frailty is currently having on outcomes in kidney transplantation. Also in kidney transplantation, studies examine the potential effects steroid withdrawal has on therapeutic tacrolimus levels, and look at the effects transplant biopsy itself has on donor-derived cell-free DNA measurements. In liver transplantation, a case is presented which alerts transplant clinicians about potential organ perfusion anaphylaxis caused by machine perfusion with epoprostenol, and in experimental lung transplantation (cynomolgus macaques), there is an interesting report on lack of immunological tolerance using a modern mixed-chimerism protocol that was reportedly effective for kidney transplants. Another investigation looks at whether IVIG treatment can affect screening for donor-specific antibodies in patients. On the topic of organ donation, the experimental effects of donor age (in rats) in the DCD setting on ischemic heart damage are tested; there are also reports on a case of multi-organ donation after liquid nicotine intoxication, and on a pilot program aimed to optimize overweight/steatotic donors for living liver donation. Related to infectious diseases impacting transplantation, an evaluation of SRTR data in the U.S. provides interesting data on the geographic distribution of CMV risk. For complete details on these articles, and more, please visit our open access Transplantation Direct website.

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