REVIEW: PDF OnlyThe human microbiome in transplantation the past, present, and futureDery, Kenneth J.a; Kupiec-Weglinski, Jerzy W.a; Dong, Tien S.bAuthor Information aThe Dumont-UCLA Transplantation Center, Department of Surgery, Division of Liver and Pancreas Transplantation bDepartment of Medicine, Vatche & Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA Correspondence to Tien S. Dong, 650 Charles E. Young Dr S, CHS 44-133, Los Angeles, CA 90095, USA. Tel: +1 310 206 6186; e-mail: [email protected] Current Opinion in Organ Transplantation: September 20, 2021 - Volume - Issue - doi: 10.1097/MOT.0000000000000922 Buy PAP Metrics Abstract Purpose of review Over the past 20 years, DNA sequencing technology has transformed human microbiome research from identity characterizations to metagenomics approaches that reveal how microbials correlate with human health and disease. New studies are showing unprecedented opportunity for deep characterization of the human microbial ecosystem, with benefits to the field of organ transplantation. Recent findings In the present review, we focus on past milestones of human-associated microbiota research, paying homage to microbiota pioneers. We highlight the role of sequencing efforts to provide insights beyond taxonomic identification. Recent advances in microbiome technology is now integrating high-throughput datasets, giving rise to multi’omics − a comprehensive assessment modeling dynamic biologic networks. Studies that show benefits and mechanisms in peritransplant antibiotic (Abx)-conditioned recipients are reviewed. We describe how next-generation microbial sequencing has the potential to combine with new technologies like phage therapy (PT) to translate into life-saving therapeutics. Summary The study of the microbiome is advancing the field of transplantation by enhancing our knowledge of precision medicine. Sequencing technology has allowed the use of the microbiome as a biomarker to risk stratify patients. Further research is needed to better understand how microbiomes shape transplantation outcomes while informing immune cell - tissue crosstalk platforms. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.