On the cover this month: In 2011, belatacept was approved for use in kidney transplantation. Though its uptake by the transplant community has been gradual, owing at least in part to the many new mechanistic and logistical paradigms associated with its use, it is gaining a foothold in clinical practice. This month we feature several articles relevant to the growing use and acceptance of belatacept in clinical transplantation, including the final results of the pivotal BENEFIT-EXT study (Durrbach et al, page 3192), a registry analysis of postapproval use of belatacept (Wen et al, page 3202), and two articles describing expanded clinical use of belatacept. Ebcioglu et al (page 3278) describe belatacept use in an HIV-positive patient, and Krezdorn et al (page 3305) report on the use of belatacept in face transplantation. Also this month, we present the “What's Hot, What's New” summary of the 2016 American Transplant Congress (Levitsky and Gill, page 3105), and an overview article from the ASTS Scientific Studies Committee (Fayek et al, page 3093) with a useful summary of the SRTR data on liver transplantation. Cover design by Lauren Halligan, Duke University Department of Surgery.

This issue's edition of “The AJT Report” covers highlights from the International Pancreas and Islet Transplant Association Key Opinion Leaders Meeting on Stem Cell Derived Beta Cells, held in September in Boston.

Cho and colleagues explore the impact of pO2 levels on germinal center B cell responses and demonstrate that sensing oxygen deprivation results in hypoxia-induced factor-dependent reduction of high affinity IgG class-switched responses.

The authors address current limitations of phenotyping chronic lung allograft dysfunction and stress the need for uniform diagnostic criteria, including an important role for imaging. See Suhling et al's article (page 3163).

Braun et al's observations (page 3181) that nonstandard exception requests for pediatric end-stage liver disease points are tied to waitlist and posttransplant outcomes raise the question if the liver transplant community can better serve all children awaiting transplantation in accordance with the Final Rule.

By reducing the preservation injury incurred by cold storage and facilitating a period of organ evaluation, normothermic ex vivo liver perfusion may provide an avenue for increasing the utilization of donation after cardiac death steatotic and advanced age livers for transplantation. See the brief communication from Mergental et al on page 3235.

Development of new immunosuppressive regimens for transplantation has come to a standstill, leading the authors to urge for substantial change of the current regulatory requirements and endpoints for new agent approval.

Chung et al review emerging knowledge about the role of Notch signaling in alloreactivity and the therapeutic potential of targeted Notch inhibition to prevent organ rejection.

The authors summarize data from recent literature on clinical outcomes of increasing utilization of kidneys from unconventional and higher-risk deceased donors.

The ASTS Scientific Studies Committee and Council perform a systematic review of the 2014 Scientific Registry of Transplant Recipients and report on liver transplant and future prospectives.

This report highlights and summarizes select novel presentations in basic, translational and clinical transplantation science delivered at the 2016 American Transplant Congress in Boston.

This article outlines the rationale for a continued embargo of academic exchange with the Chinese transplantation community, given the absence of transparent and ethically verifiable sourcing of organs from voluntary donors as required by international law. See Letter to the Editor from O'Connell et al on page 3297 and a response from Sharif et al on page 3299.

This pilot study introduces a novel approach to increase availability of livers for transplantation using normothermic machine perfusion to test the function of declined organs, reporting feasibility of this approach in five patients receiving such livers that met predefined viability criteria. See the editorial from Barbas and Knechtle on page 3075.

In an experimental mouse model, Espes et al demonstrate excellent revascularization and oxygenation of mouse and human pancreatic islets transplanted to the omentum as well as superior graft function when compared to the intraportal site. See the supplemental video at amjtransplant.com/videos.

A prospective, randomized, multicenter, double-blind, placebo-controlled clinical study shows the failure of tacrolimus withdrawal in highly stable kidney transplant patients.

The authors investigate the utility of parametric response mapping (voxel-to-voxel comparison of inspiratory and expiratory CT scans) in quantifying bronchiolitis obliterans syndrome diagnosis and progression.

Older recipients who undergo staged bilateral lung transplantation for interstitial lung disease have comparable survival and pulmonary function tests to single lung and bilateral lung transplant recipients with lower incidence of renal injury compared to conventional bilateral recipients.

The authors describe the first successful use of belatacept to improve renal function in a kidney transplant recipient with HIV.

Ex vivo normothermic perfusion allows the transplantation of two kidneys deemed untransplantable by all UK centers due to inadequate in situ perfusion.

This case report demonstrates the value of following dilution patterns of different antibodies within a single serum sample as a potential indicator for identifying and grouping HLA antibodies that recognize a shared epitope.

This report summarizes the recommendations for this year's influenza vaccine administration.