End-stage liver disease secondary to alcoholic cirrhosis conThe prediction of abstinence from ethanol may be tinues to be a significant cause of death. 1 Most alcoholics with crucial to the optimal selection of liver transplantation end-stage liver disease do not have significant extrahepatic candidates with alcoholism. Of 84 consecutive end-stage complications of ethanol abuse. 2 Therefore, these patients are alcoholic patients who underwent transplantation not usually excluded because of other terminal medical condi-(1986-1994) at our institution, we analyzed 63 long-surtions, and many times will die shortly without transplantaviving recipients for pretransplantation variables to tion intervention. 2 Furthermore, excellent survival following predict posttransplantation abstinence (follow-up: 49.3 liver transplantation is noted with alcoholic recipients. [3][4][5][6][7][8][9][10][11] Be-{ 21 mo). Thirty-three pretransplantation variables cause these patients usually have liver disease solely because were reviewed from our transplantation data base and of the intake of a toxin (ie, ethanol), abstinence from this supplemented and confirmed with interviews with retoxin usually predicts minimal problems with liver disease cipients. The psycho-social inclusion criteria included following liver transplantation. The appropriate allocation of the following: patient recognition of alcoholism, a domiliver transplantation to specific alcoholic patients is made cile, an occupation, and at least one close personal relamore difficult by the large number of patients with end-stage tionship. The incidence of abstinence from ethanol was alcoholic cirrhosis and the intense demand for donor organs (50/63) 79%. A logistic regression of the 33 variables in for other end-stage liver diseases in which disease recurrence conjunction with our above inclusion criteria accurately may be less likely or more predictable. 12-14 Herein lies the predicted abstinence (90% accuracy, x 2 model, P õ problem that besets transplantation physicians: the appro-.00001) based on the absence of previous history of any priate selection of alcoholics with end-stage liver disease for illicit drug use (Drug Use: yes Å 1/no Å 0), the presence transplantation based on the prediction of long-term abstiof an active, personal life insurance policy (Life Ins: yes nence from alcohol. number of alcoholic sisters (ETOH-SIS), andThe aims of this study are to describe the following: 1) the the length of pretransplantation abstinence (PREresults of liver transplantation for patients with alcoholic TRANS-ABS, mos): Prob. of abstinence Å 1/1 / e 0F , F Å end-stage liver disease (survival, the incidence of abstinence, 00.33 / 0.89 (DRUG USE) 01.02 (LIFE INS) 01.68 (ETOHand pattern of recidivism); and 2) an analysis of pretrans-SIS) /0.24 (PRE-TRANS-ABS). In contrast, receiver-opplantation variables that may predict abstinence from alcohol erating characteristic curve analysis found that 7 and 9 following transplantation. months of pretransplantation abstinence were the be...

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Patients with ESRD had less severe hepatitis C than did control subjects. Clinical measurements did not predict histologic findings in renal transplant candidates. Transjugular liver biopsy should be considered to stage hepatitis C in renal transplant candidates due to the risk of percutaneous biopsy in uremic patients.

Leflunomide seems to possess substantial immune suppressive potency in renal and liver transplant recipients and may be safely dosed for more than 300 days. The data suggest that calcineurin phosphatase inhibitors and prednisone can be safely reduced in patients with serum levels of active drug above 50 microg/mL. Because of a wide inter-patient range of active metabolite terminal half-life (>300%), monitoring of serum levels would seem to be an important part of its evaluation.

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Nondepleting anti-CD4 mAbs but not CD28 antagonists protect islet grafts in diabetic NOD mice from autoimmune destruction and allogeneic and xenogeneic graft rejection. The efficacy of nondepleting anti-CD4 mAbs is compromised when it combines with CTLA4Ig.

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Lef preventing concordant xenogeneic islet graft rejection is not sufficient to prevent the recurrence of autoimmune diabetes in NOD mice. We believe that controlling autoimmunity after islet transplantation will lead the way to promote successful clinical islet transplantation in the future.