IP was measured by lactulose and mannitol excretion ratio (LMR) in patients and 50 healthy controls (HC). Serum endotoxin levels were also assessed in 48 patients and 20 HC. Results:  Eighty patients (74 male), 41 (51.3%) Child B and 56 (70%) Child C, with a mean age of 40.7 ± 9.8 years were enrolled. IP was increased in 28 (35%) patients. LMR of patients was higher than HC (patients vs HC = 0.0238 [0.0010–1.557] vs 0.0166 [0.0018–0.720]; P = 0.007]. No significant difference was seen in the LMR of patients among various Child classes and etiologies. Serum endotoxin levels (GMU/mL) were higher in patients than HC (patients vs HC = 1.42 [0.68–2.13] Smoothened Agonist vs 0.994 [0.067–1.382]; P = 0.001), but comparable between

patients with abnormal and normal IP. At follow up, there was no significant difference in the incidence of complications like spontaneous bacterial

peritonitis, HRS, VB, HE and death between patients with abnormal and normal IP. Conclusion:  IP was increased in 35% of patients with LC; however, it was not associated with a higher incidence of disease-related KU-57788 cost complications. “
“Background: Graft local infusion and splenectomy have been established as pivotal strategies in ABO incompatible (ABO-I) living donor liver transplantation (LDLT). However, these procedures are associated with high rates of intraoperative and postoperative complications. Methods: From January 2012 to January 2013, 13 consecutive ABO-I LDLT patients were identified at National Cancer Center, Republic of Korea. Our protocol 上海皓元 involved rituximab (300 mg/m2) at preoperative 2 weeks, followed by plasma exchange (target before LDLT: isoagglutinin titer ≤ 1:8), basiliximab (20 mg on operation day and postoperative day 4),

and intravenous immune globulin (0.8 g/day at postoperative day 1 and 4) without graft local infusion and splenectomy. Results: The 13 patients (10 males, three females) who underwent transplantation comprised liver cirrhosis (n=3) and hepatocellular carcinoma (n = 10). The median isoagglutinin antibody titer before plasma exchange was 1:32 (range, 1:4 – 1:256). All patients are alive without graft failure. There was no hyperacute rejection and antibody-mediated rejection. Mean duration of hospital stay was 13.2 days. There was no recurrence of hepatitis B virus (0/10 patients), but recurrence of hepatitis C virus (1/1 patient) and one positive CMV antigenemia (1/13 patients) after transplantation. No bacterial and fungal infections were observed. Complications included herpes zoster viral infection in one patient, postoperative bleeding in one patient and extrahepatic biliary stricture in three patients. Conclusions: The new simplified ABO-I LDLT protocol using rituximab, plasma exchange, basiliximab, and intravenous immune globulin without graft local infusion and splenectomy showed good graft outcomes without hyperacute, antibody mediated rejection, and serious infection.