Abstract

On the Cover: This month, AJT presents numerous articles addressing infectious diseases, particularly as they relate to one another and the numerous biological changes associated with clinical transplantation. Zhang et al (page 2421) present a novel model associating CMV reactivation with ischemia–reperfusion injury and a “second hit” of immunosuppression that facilitates latent viral reactivation. Similarly, L'Huillier et al (page 2495) nicely relate CMV to blunted toll-like receptor activation, and through this, an altered response to many other infectious pathogens. Also, see articles by Reischig et al (page 2457), Anesi et al (page 2468) and Giménez et al (page 2479) for studies relating our therapeutic approaches toward infection, namely antiviral prophylaxis and antibiotic exposure, to subsequent infectious disease risk. Several thoughtful editorials provide broader perspectives on these articles, and many others, all addressing the perennial challenges of infectious risk in transplant patients. Also, Al Ammary et al (page 2614) describe an emerging trend of decreasing living related donation in the face of increasing unrelated donation. Cover design by Megan Llewellyn, Duke University Department of Surgery.

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