SUMMARY An overview of the condition of intestinal transplantations in the Middle East shows that the issue of intestinal failure and the treatment facilities still remain an unsolved problem. Although there exists a high need for intestinal transplantation, advances in reconstructive surgeries and the development of parenteral nutrition in this region can significantly reduce the need for intestinal transplantations among patients with intestinal failure.PURPOSE OF REVIEW Since 2014, the liver transplant community has been debating the pros and cons of broader sharing. Over the last 6 years, lung and heart transplantation have moved to broader sharing based on 'zones' or circles around a donor hospital, with the Organ Procurement and Transplantation Network (OPTN) approving a broader kidney sharing proposal in December of 2019 (set to be implemented in December 2020). RECENT FINDINGS In 2017, the OPTN Board of Directors approved a broader sharing policy in liver transplantation that was rooted in expanding the first-line of liver sharing beyond the donor service area (DSA). Faced with the threat of litigation, this proposal was replaced with a circle-based sharing policy titled 'Acuity Circles'. After a long legal challenge, the implementation of this new policy was delayed from April 2019 until February 2020. SUMMARY In this review, concerns related to broader sharing in liver allocation will be addressed, in terms of the basis for broader sharing and the potential implications to liver transplantation, rooted in the Final Rule and concerns around variability in organ donation rates and access to the waiting list.PURPOSE OF REVIEW This review features articles published during 2018 and 2019 regarding pediatric visceral transplantation in Europe. In this biannual review, the authors identify and summarize key articles pertinent to clinical and research areas. RECENT FINDINGS There is a trend to a lower use of intestinal transplantation in pediatric population in Europe. Most articles were focused in long-term follow-up. The burden of the disease 10 years after intestinal transplantation is still significant, including the need of several medications, readmissions, and the need of specific follow-up, mostly because of psychiatric problems. Regarding eating behaviors, promoting eating pretransplant may be protective and there may be eating difficulty predictors that could be used to facilitate targeted interventions. Two different articles were consistent in the identification of C1q-fixing DSA as a marker of poor outcome, and capillaritis was identified as a predictor of C4d positivity in intestinal graft biopsies. The inclusion of the liver emerged as the main protective factor against dnDSA development. The incidence of PTLD (specially the monomorphic type) was significantly higher following ITx than after LTx (14.9 vs. 2.8%). The European societies and the EU have made an effort to promote networking, collaborative registries, and sharing of knowledge in pediatric transplantation. SUMMARY Recent articles focused mostly on long-term follow-up issues, although translational research has also been sustained by some groups.PURPOSE OF REVIEW In Europe, adult intestinal transplantation (ITx) has continuously evolved since the first successful case in 1989. However, despite several recent innovations, no significant improvement in survival has been seen since 2005, illustrating the unique difficulty of transplanting the intestine. In this review, a subanalysis of adult ITx in Europe is discussed and recent publications on adult ITx in Europe are presented. RECENT FINDINGS Increased medical and surgical arsenal in the treatment of intestinal failure reduce the need for ITx. At the same time, new indications (diffuse ischemia) have emerged. Static cold storage after vascular flush remains the gold standard but promising results are shown with additional luminal preservation. Pretransplant embolization facilitates multivisceral transplantation. Chronic rejection remains a major difficulty to tackle and currently, liver inclusion is the only effective strategy. Treatment of graft-versus-host-disease remains debated. Quality of life substantially improves after successful ITx. ITx becomes cost-effective three years after transplantation.  https://www.selleckchem.com/products/BIBW2992.html  SUMMARY ITx remains more challenging than other solid organ transplants. However, long term outcome, particularly after combined liver and ITx, is excellent and similar to other solid organ transplants. Further studies are warranted to tackle the fundamental immunobiological challenge that ITx represents.PURPOSE OF REVIEW Intestinal transplantation (ITx) activity remains low in East Asia. We conducted a multinational, retrospective study on patients who underwent ITx in Korea, Taiwan, and Japan, to provide an overview and to foresee future developments and collaborations in this region. RECENT FINDINGS Total 71 ITx were performed in 67 patients. Living donor ITx was most commonly conducted in Japan (n = 13). Despite the low caseload, all three countries demonstrated acceptable patient survival rates of approximately 70% at 5 years. Over 70% of recipients with a functioning graft were free from total parenteral nutrition. SUMMARY There is an urgent need to establish a nationwide and multinational registry of ITx recipients and patients with intestinal failure in East Asia. An efficient referral system to specialized intestinal rehabilitation and ITx centers and a multidisciplinary team approach is also warranted to provide state-of-the-art treatment for patients desperately waiting for a chance to survive.PURPOSE OF REVIEW To describe the historical and evolving role of quality oversight in the field of transplantation. The review highlights of the prior use and effects of oversight of solid organ transplant centers and discusses potential ramifications of changes for the field. RECENT FINDINGS There have been a number of studies illustrating unintended consequences associated with regulatory oversight. Although the intent of oversight to ensure safety and high quality of care, research highlights the potential deleterious effects of policies that do not consider the complexities and effects on practice, patient selection and utilization of donor organs in this field. Recent amendment of policy by the Center for Medicare and Medicaid Services (CMS) highlight the recognition and prominence of these concerns and potentially expand opportunities for transplantation prospectively. SUMMARY The historical development and implementation of regulatory reporting in transplantation is unique and the oversight imposed on transplant organizations is particularly high compared with other healthcare contexts.