Joanna A. Leithead, James W. Ferguson, Peter C. Hayes – 30 July 2008 – Smoking is the world's leading cause of premature mortality responsible for an estimated 5 million deaths each year. Although the negative health implications of cigarette smoking in the nontransplant setting are well recognized, the effect on patient and graft survival post liver transplantation remains unclear. The aim of this study was therefore to assess the influence of smoking on morbidity and mortality following liver transplantation.

Jennifer Tan, Bijal Surti, Sammy Saab – 30 July 2008 – As the treatment of cirrhosis improves, pregnancy in patients with cirrhosis is likely to become more common. Although maternal and fetal mortality is expected to similarly improve, pregnant patients with cirrhosis face unique risks. These include higher rates of spontaneous abortion and prematurity and a potential for life‐threatening variceal hemorrhage, hepatic decompensation, splenic artery aneurysm rupture, and postpartum hemorrhage.

Masashi Narita, Robert R. Muder, Thomas V. Cacciarelli, Nina Singh – 30 July 2008 – Prototheca species are unicellular algae of low virulence that are rarely associated with human infections. We report a liver transplant recipient with disseminated protothecosis and review the literature on this unusual opportunistic infection in transplant recipients. Of 9 cases, including ours, 5 had a localized infection, and 4 had disseminated protothecosis. Seven cases were due to Prototheca wickerhamii, and 2 were due to Prototheca zopfii.

Olga N. Tucker, Paul Marriott, Mohamed Rela, Nigel Heaton – 30 July 2008 – Liver trauma is a major cause of mortality after major blunt and penetrating abdominal trauma. The need for life‐saving emergency hepatectomy and liver transplantation is extremely rare. We report the management of 2 patients who required urgent liver transplantation for liver trauma. One patient developed hepatic failure following global ischemia after a gunshot injury. The second patient developed a severe postreperfusion injury following removal of a perihepatic pack after blunt abdominal trauma.

Michael Green, George V. Mazariegos – 30 July 2008

Guang Yu Jin, Hee Chul Yu, Hyung‐Sun Lim, Jang Il Moon, Jeong Hun Lee, Jin Wook Chung, Baik Hwan Cho – 30 July 2008 – The threat of ischemic complications following massive resection, especially in living donor hepatectomy or split liver transplantation, has been haunting surgeons for many years. Postmortem dissections of 62 livers were performed to investigate anatomical variations of the principal artery for segment 4 (A4). The origin of A4 was examined separately in the liver with (n = 46) or without (n = 16) an aberrant left hepatic artery (abLHA).

Rajasekhar Tanikella, George M. Philips, Dorothy K. Faulk, Steven M. Kawut, Michael B. Fallon – 30 July 2008 – Hepatopulmonary syndrome (HPS) results when chronic liver disease or portal hypertension causes intrapulmonary microvascular dilatation with hypoxemia. In experimental HPS, tumor necrosis factor alpha (TNF‐α) overproduction contributes to vasodilatation, which is improved by pentoxifylline, a TNF‐α inhibitor. The effectiveness of pentoxifylline in humans is unknown.

James D. Perkins – 30 July 2008

Mitchell L. Shiffman, Don C. Rockey – 30 July 2008 – Liver transplantation has evolved into a successful option for patients with end‐stage liver disease. Transplant hepatologists are involved in the management of patients with end‐stage liver disease both before and after liver transplantation. The goals of this study were to evaluate the roles that transplant hepatologists play at liver transplantation programs in the United States and the demand for and institutional support provided for these physicians.

Valentina Medici, Lorenzo Rossaro, Jacob A. Wegelin, Amit Kamboj, Junko Nakai, Kelli Fisher, Frederick J. Meyers – 30 July 2008 – Patients with chronic liver disease are referred late to hospice or never referred. There are several barriers to timely referral. First, liver transplantation (LT) and hospice care have always been perceived as mutually exclusive. Yet the criteria for hospice referral and for LT are more similar than different (for example, advanced liver disease and imminent death). Second, physicians, patients, and families have not had a reliable metric to guide referral.