In a country with a population of around 23 million, obesity is becoming a major epidemic in Australia and an increasingly common practice is to transplant patients who are morbidly obese with a component of non-alcoholic steatohepatitis or non-alcoholic fatty liver. The aim of the Australian National Liver Transplantation Unit (ANLTU) is to reduce the recurrence of steatosis in the transplanted graft and assist patients to make a lifelong change in dietary behaviour. This will, in turn, increase graft and overall survival rates and reduce obesity-related comorbidities in this cohort.

I was privileged in 2019 to receive the Astellas Practice Development Travel Grant which allowed me the opportunity to attend the American Transplant Congress (ATC) and the Transplant Infectious Diseases (TID) Symposium in Boston, USA. In addition, I was able to attend several reserved offsite meetings with international experts in the fields of transplant infectious diseases and transplant frailty. This included a supernumerary clinical attachment to the University of Pittsburgh Medical Centre Abdominal Transplant Unit and the attached Thomas E Starzl Transplantation Institute. This paper summarises highlights which I think will be interesting and educational for colleagues, and provides reflections on several informative and clinically valuable interviews and observations during this experience. I hope to also encourage members of the TNA to embrace the opportunity to apply for this generous practice development grant.