On the cover this month: AJT presents the output from the 2017 Banff consortium for kidney allograft pathology (Haas et al, page 293), including revisions to the diagnostic criteria for T cell– and antibody-mediated kidney transplant rejection, specific criteria for chronic active T cell–mediated rejection, and prospects for integrative endpoints in clinical trials. Two Original Articles from Nankivell et al (page 364) and Lefaucheur et al (page 377) influence the new Banff recommendations regarding the relationship between T cell–mediated rejection and areas of interstitial scarring. We also present a new Banff classification for tissue engineering pathology in bioengineered organs and tissues for transplantation that will increasingly be used as prosthetic devices and tissue engineering become more common. Finally, be sure to read the “What's Hot, What’s New” feature from the 2017 American Transplant Congress! Cover image by Lauren Halligan, Duke University Department of Surgery.

This month's installment of “The AJT Report” covers the recent hurricanes that devastated Puerto Rico and Houston, which necessitated prompt action and keen judgment by local hospitals on behalf of transplant patients, and shed a light on emergency response areas that require attention.

Dendritic cells’ metabolism determines their adjustment to specific tissues and the type of adaptive immunity they instruct following inflammatory challenges.

Novel use of inhaled antifungal therapy is of interest to minimize systemic toxicity and drug–drug interactions while improving drug delivery directly to the site of infection. See the case report from Solé et al on page 504.

This minireview introduces the novel concept of allorecognition by monocytes and macrophages, and summarizes the current understanding of its mechanisms and relevance to transplantation.

The Banff consortium presents revisions to the diagnostic criteria for T cell– and antibody-mediated kidney transplant rejection, including specific criteria for chronic active T cell–mediated rejection, plus prospects for integrative endpoints in clinical trials. See related articles on pages 321, 364, and 377.

The authors highlight the most impactful presentations from the 2017 American Transplant Congress.

The new Banff classification of tissue engineering pathology will characterize the pathologic abnormalities in bioengineered organs and tissues for transplantation, and will increasingly be used with the existing Banff classification of allograft pathology as prosthetic devices and tissue engineering become more common. See related articles on pages 293, 364, and 377.

The authors describe the development and implementation of a protocol for trimethoprim-sulfamethoxazole adverse drug reaction assessment and rechallenge in renal transplant recipients, and report a safe increase in first-line Pneumocystis pneumonia prophylaxis and reduction in costs.

In a high-volume pancreas transplant center, the authors examine the prevalence and outcomes of cystic lesions of the transplant pancreas with a proposed management algorithm.

This study evaluates the efficacy of low-dose recombinant collagenase enzyme mixture and identifies its beneficial effect on human islet yield and function.

A medical record review suggests that imminent death organ donation could provide thousands more kidneys in the United States every year and substantially reduce the nation's kidney waiting list.

This study provides evidence for the judicious utilization of organs donated from prior transplant recipients as another form of expanded criteria donor.

This report describes the successful use of topical posaconazole as salvage therapy for tracheobronchial and lung Scedosporium invasive infections in lung transplant recipients. See the editorial by Thompson III and Patterson on page 287.

With increasing numbers of human immunodeficiency virus–positive individuals receiving organ transplants, and in some cases serving as organ donors, greater awareness of the risk factors for posttransplant Kaposi's sarcoma and measures to reduce its occurrence may be warranted.

This article reviews interventions to improve adherence to medications in individuals with chronic medical issues, such as those seen in transplantation.