Rabbit anti-thymocyte globulin (rATG)-based immunosuppression induction is being increasingly used in liver transplantation (LT) in conjunction with steroid-free protocols to delay the initiation of calcineurin inhibitors. This study reports a single-center comparison of transplant outcomes and complications in 3 immunosuppression eras. Data were obtained retrospectively from a center research database, and the analysis included LT patients from 2001 to 2008. The immunosuppression consisted of rATG induction in 3 doses (6 mg/kg in all): (1) the first dose was administered perioperatively [the rabbit anti-thymocyte globulin in the operating room (rATG-OR) era]; (2) the first dose was delayed until 48 hours after transplantation [the rabbit anti-thymocyte globulin after a delay (rATG-D) era]; or (3) the first dose was delayed until 48 hours after transplantation, and a single dose of rituximab was added 72 hours after transplantation [the rabbit anti-thymocyte globulin after a delay plus rituximab (rATG-D-Ritux) era]. The initial maintenance immunosuppression was tacrolimus monotherapy, which was started on postoperative day 2. There were 166 patients (16%) in the rATG-OR era, 259 patients (26%) in the rATG-D era, and 588 patients (58%) in the rATG-D-Ritux era (1013 patients in all). Demographically, the latter eras were characterized by higher recipient and donor ages; greater percentages of liver-kidney transplants, hepatocellular carcinoma (HCC), donation after cardiac death (DCD), and imported organs; and shorter graft ischemia times. There were no significant differences between the 3 immunosuppression groups in unadjusted patient survival 3 and 5 years after transplantation (80% and 75% for the rATG-OR era, 75% and 67% for the rATG-D era, and 79% and 71% for the rATG-D-Ritux era, P ¼ 0.15). The 5-year survival rates for patients with hepatitis C virus (HCV) and HCC were 65% and 68%, respectively. The factors included in the Cox regression model for patient death included the Model for End-Stage Liver Disease score [hazard ratio (HR) ¼ 1.03, P ¼ 0.001], HCV (HR ¼ 1.28, P ¼ 0.04), donor age (HR ¼ 1.01, P ¼ 0.001), recipient age (HR ¼ 1.01, P ¼ 0.05), and DCD (HR ¼ 1.55, P ¼ 0.11). rATG-based induction immunosuppression can be safely used in adult LT recipients with excellent survival and low rejection rates and without increases in immunosuppression-related side effects. Liver Transpl 18: 786-795, 2012. V C 2012 AASLD. Received November 19, 2011 accepted January 7, 2012. Abbreviations: CI, confidence interval; CMV, cytomegalovirus; DCD, donation after cardiac death; DVT, deep venous thrombosis; GFR, glomerular filtration rate; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HR, hazard ratio; LT, liver transplantation; MELD, Model for End-Stage Liver Disease; PTLD, posttransplant lymphoproliferative disorder; rATG, rabbit antithymocyte globulin; rATG-D, rabbit anti-thymocyte globulin after a delay; rATG-D-Ritux, rabbit anti-thymocyte globulin after a delay plus rituximab; rATG-OR, rabbit anti-thymoc...

In this paper, we proposed an improved data hiding scheme to embed secret data in the compressed bitstreams where the quality of the image is maintained even after embedment. The difference in the quantized values for each block is used to determine whether only 1 bit of secret is to be hidden for the block or to toggle bits in the bitmap to hide more bits. The scheme has a high payload and is a no distortion data hiding. Experimental tests with Lena showed that in the 2x2 block-sized BTC compressed bitstreams, an additional 10 488 bits were embedded and 416 bits for the 46x4 block-sized. The new improved scheme increases payload and is reversible

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We introduce a new secret sharing scheme, where the novelty lies in the use of a fixed angle segmentation technique to create circular shadow images called shares. In this way, the shares can be stacked in different angles to reveal different secret messages. The participants must be in possession of both the shares and the stacking angles, which creates the additional degree of protection. © 2005 SPIE and IS&T.

The significance of donor-specific antibodies (DSA) is not well known in the setting of pancreas transplantation. Since December 2009, we prospectively followed pancreas transplant patients with single-antigen-luminex-bead testing at one, two, three, six, and then every six months for the first two yr. Thirty-five of the 92 patients that underwent pancreas transplantation (13 pancreas-alone [PTA], 20 with a kidney [SPK], and two after a kidney [PAK]) agreed to participate in study. Median age at transplant was 45 yr and follow-up was 23 months. Majority were Caucasian (n = 33) and male (n = 18). Rabbit anti-thymocyte globulin induction was used. Median HLA-mismatch was 4.2 ± 1.1. Eight patients (7SPK, 1PAK) developed post-transplant DSA at median follow-up of 76 d (26-119), 1 SPK had pre-formed DSA. Seven patients had both class I and class II DSA, one with class I and one with class II only. Mean peak class I DSA-MFI was 3529 (±1456); class II DSA-MFI was 5734 (±3204) whereas cumulative DSA MFI (CI + CII) was 9264 (±4233). No difference was observed in the patient and donor demographics among patients with and without DSA. One patient in non-DSA group developed acute cellular rejection of pancreas. From our data it appears that post-transplant DSA in pancreas allograft recipients may not impact the early-pancreatic allograft outcomes. The utility of prospective DSA monitoring in pancreatic transplant patients needs further evaluation and long-term follow-up.

et al. 26PA combination of resistance mechanisms is frequent in nonsmall cell lung cancer (NSCLC) that progressed to EGFR tyrosine kinase inhibitors (TKIs).