Transplantation Direct for January is now online and features a wide range of topics. We have a number of articles in kidney transplantation, including prehabilitation strategies in recipient candidates, factors in deceased donors contributing to acute kidney injury, postural venous outflow problems in pregnant recipients, outcomes using high KDPI kidneys in older recipients, data on whether patiromer interacts with tacrolimus, and a first-in-human safety study on using alpha-1-microglobulin to improve kidney function. In liver transplantation, we have reports on the impact of machine perfusion (MP) on organ usage and DCD graft survival in the USA, and on the dynamics of ischemia-reperfusion injury markers in normothermic MP; there is also a comparison of transplant outcomes using 6 predictive scoring models, a study on using cardiovascular fitness tests in recipients, and a report on factors related to invasive surgical site infections. Experience using non-vascularized rectus fascia transplantation in intestinal and multi-visceral recipients is described. On the topic of organ donation, an analysis was performed on whether EBV and CMV infections can be mitigated by kidney-paired donation practices, and a study plan is described from Canada related to legislation that determines the impact of deemed consent methodologies. In the increasingly emerging practice of uterus transplantation, kinetic parameters are assessed related to immunological rejection. Indeed, this entire issue of Transplantation Direct is available by open access; please visit our website for complete details.