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There is also a 6AT transmission reflash to help smooth out the shifting. It improved my hwy mpgs when I traveled in the southwest with my 11 MDX (NM, AZ, Utah, and CO). The reflash wasn't applied to 10-11 MDXs; but, was standard for the 12-13 models.

Age instead of mileage seems to be your main service concern. You might have to look into replacing the serpentine belt, timing belt, coolant, battery, and tires in the next few years if they are all original.
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