David R. Nelson, Consuelo Soldevila‐Pico, Alan Reed, Manal F. Abdelmalek, Alan W. Hemming, Willem J. van der Werf, Richard Howard, Gary L. Davis – 30 December 2003 – The pathogenesis of hepatitis C virus (HCV) recurrence after liver transplantation (LT) is poorly understood, but the cellular immune response is likely to have a major role. Daclizumab, an interleukin‐2 receptor (IL‐2R) antibody that blunts T‐cell activation, leading to a decreased risk for cellular rejection, is used frequently in transplant recipients.

Lars E. Schmidt, Vibeke Rømming Sørensen, Lars Bo Svendsen, Bent A. Hansen, Fin Stolze Larsen – 30 December 2003 – The aim of this pilot study is to evaluate the circulatory safety of treatment with the molecular adsorbents recirculating system (MARS) by determining the effect on systemic hemodynamics of a single MARS treatment in patients with acute‐on‐chronic liver failure (AOCLF). In eight patients admitted with AOCLF, a single 10‐hour MARS treatment was performed. Systemic hemodynamic variables were determined before and during treatment.

Thomas P. Beresford – 30 December 2003 – Key Points 1Mental status changes are often the earliest indication of an untoward complication after transplantation.

I. Quintus Molenaar, Cristina Legnani, Theo H.N. Groenland, Gualtiero Palareti, Bruno Begliomini, Onno T. Terpstra, Robert J. Porte – 30 December 2003 – Aprotinin reduces blood transfusion requirements in orthotopic liver transplantation (OLT). Concern has been voiced about the potential risk for thrombotic complications when aprotinin is used. The aim of this study is to evaluate the effects of aprotinin on the two components of the hemostatic system (coagulation and fibrinolysis) in patients undergoing OLT.

Edward Gologorsky, Andre M. De Wolf, Victor Scott, Shushma Aggarwal, Michael Dishart, Yoogoo Kang – 30 December 2003 – Intravascular and/or intracardiac thrombus formation followed by pulmonary thromboembolism with right ventricular dysfunction immediately after graft reperfusion during orthotopic liver transplantation (OLT) is described in 7 patients. This complication may have been related to excessive activation of the coagulation system by graft reperfusion, which overwhelmed anticoagulation mechanisms and was disproportionate to fibrinolysis.

Lars E. Schmidt, Allan Rasmussen, Mette Rindom Nørrelykke, Henrik Enghusen Poulsen, Bent Adel Hansen – 30 December 2003 – Mycophenolate mofetil (MMF) is a prodrug immunosuppressant with a high oral bioavailability. Enterohepatic cycling of a glucuronide derivative of MMF contributes substantially to the bioavailability, but is dependent on bacterial deglucuronidation by intestinal flora. This study aims to determine whether an antibiotic regimen with activity against such organisms reduces the bioavailability of MMF by impairing enterohepatic cycling.

Mary Ann Huang, Thelma Wiley, Catherine McIsaac – 30 December 2003

Daniel H. Kett, Rita C. Acosta, Michael A. Campos, Miguel J. Rodriguez, Andrew A. Quartin, Roland M.H. Schein – 30 December 2003 – We report a case of portopulmonary hypertension in which the pulmonary hypertension resolved after initial orthotopic liver transplantation. Portopulmonary hypertension recurred when the transplanted liver failed and again resolved after a second liver transplantation. Intravenous epoprostenol was administered perioperatively to control the pulmonary hypertension in both instances.

Rafik M. Ghobrial, Chung‐Bao Hsieh, Susan Lerner, Sharon Winters, Nicholas Nissen, Sherfield Dawson, Farin Amersi, Pauline Chen, Douglas Farmer, Hasan Yersiz, Ronald W. Busuttil – 30 December 2003 – A right lobe graft that is drained by the right hepatic vein (RHV) is obtained by transecting the liver on the right side of the middle hepatic vein (MHV). On occasion, a small RHV that only drains a portion of the right lobe, with the predominant outflow achieved by the MHV, is encountered.

Masahiro Arai, Ronald G. Thurman, John J. Lemasters – 30 December 2003 – Brief periods of ischemia followed by reperfusion render tissues resistant against subsequent prolonged ischemia, a phenomenon called ischemic preconditioning. The effect of ischemic preconditioning on liver transplantation was investigated in relation to sinusoidal endothelial cell injury and Kupffer‐cell activation, which are prominent features of storage and reperfusion injury leading to liver graft failure.