Impact of the microbiota on solid organ transplant rejectionSepulveda, Martin*; Pirozzolo, Isabella*; Alegre, Maria-LuisaCurrent Opinion in Organ Transplantation: December 2019 - Volume 24 - Issue 6 - p 679–686 doi: 10.1097/MOT.0000000000000702 INNATE - ADAPTIVE IMMUNE INTERFACE IN ALLOGRAFT REJECTION AND SURVIVAL: Edited by Xian C. Li Buy Abstract Author InformationAuthors Article MetricsMetrics Purpose of review The microbiota in mammalian hosts can affect maturation and function of the immune system and has been associated with health and disease. We will review new findings on how this dynamic environmental factor impacts alloimmunity and therapy in transplant hosts. Recent findings The microbiota changes after transplantation and immunosuppressive therapy. New data indicate that different microbial community structures have distinct impact on graft outcome, from promoting, to inhibiting or being neutral to transplant survival. In addition, we will address reciprocal interactions between the microbiota and immunosuppressive drugs, as well as the suitability of the microbiota as a predictive biomarker and its utility as adjunct therapy in transplantation. Summary Advances in microbiome sequencing and wider availability of gnotobiotic facilities are enabling mechanistic investigations into the commensal communities and pathways that modulate allograft outcome, responsiveness to immunosuppression and side effects of drugs. A better understanding of the functions of the microbiota may help mitigate drug toxicity, predict drug dosage and dampen alloimmunity in transplant patients. Department of Medicine, University of Chicago, Chicago, Illinois, USA Correspondence to Maria-Luisa Alegre, MD, PhD, Department of Medicine, University of Chicago, 924 E. 57th Street, JFK-R312, Chicago, IL 60637, USA. Tel: +1 773 834 4317; e-mail: email@example.com Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.