Increasing numbers of children undergo successful liver transplantation. Limited data exist on long-term survival and late graft loss. Survival and graft loss were studied in 376 primary liver graft recipients who survived more than 3 months after transplantation (80.5% of all primary graft recipients). Patient records were reviewed retrospectively for causes of graft loss. Risk factors were identified by analyzing graft, recipient, and posttransplant variables using multivariate Cox regression. One-, 5-, and 10-year actuarial graft survival rates in the study population were 94.6%, 87.3%, and 86.3%, respectively. Corresponding patient survival rates were 95.7%, 91.4%, and 90.4%. Forty-seven (12.5%) grafts were lost subsequently, 15 by patient death with preserved graft function. Survival rate after late retransplantation was 63.3%. Causes of late graft loss were infection (21.2%), posttransplant lymphoproliferative disease (PTLD, 21.2%), chronic rejection (17%), biliary complications (14.8%), and recurrence of malignant disease (8.5%). Independent risk factors for late graft loss and patient death included liver malignancy as primary disease, steroid resistant rejection, and PTLD. Graft loss rate was significantly increased for reduced-size grafts. Patients undergoing transplantation after 1991 and recipients of full-size grafts were more likely to survive. In conclusion, the long-term outcome for pediatric primary liver graft recipients surviving the early postoperative period is excellent except for patients with liver malignancy. There is no increased risk of late graft loss with the use of split or living related donor grafts. Technical complications are only a minor factor in late graft loss, but complications related to immunosuppression and infection remain a major hazard and must be addressed. (Liver TranspZ2002;8:615-622.) 0 rthotopic liver transplantation (OLT) is considered standard therapy for children with end stage liver disease, fulminant hepatic failure, and selected metabolic diseases, e.g., hyperoxaluria type 11. Patient survival after OLT approaches 90% at 1 year, 85% at 5 years, and over 75% at 10 years posttransplant in experienced centers.'p2 Nevertheless about 20% of primary grafts are still failing, the majority in the early postoperative period. Much attention has been focused on early graft loss, but with improving long-term survival the risk of late graft loss is becoming an important issue. Late mortality and its causes after pediatric OLT have been analyzed,3 but there are no large-scale data concerning incidence, causes, and risk factors of late graft loss. Results of studies in adult patients are not applicable to children because of the different spectrum of diseases leading to OLT in adults. Identification of risk factors for late graft loss may help in reducing the frequency of retransplantation and, hence, the risk of patient death, which is significantly increased after retransplantation.* Furthermore, in an era of donor organ shortage and increasing financial constraints, it...

Abstract. Mitigating the proportion of energy intake lost as methane could improve the sustainability and profitability of dairy production. As widespread measurement of methane emissions is precluded by current in vivo methods, the development of an easily measured proxy is desirable. An equation has been developed to predict methane from the mid-infrared (MIR) spectra of milk within routine milk-recording programs. The main goals of this study were to improve the prediction equation for methane emissions from milk MIR spectra and to illustrate its already available usefulness as a high throughput phenotypic screening tool. A total of 532 methane measurements considered as reference data (430 AE 129 g of methane/day) linked with milk MIR spectra were obtained from 165 cows using the SF 6 technique. A first derivative was applied to the MIR spectra. Constant (P0), linear (P1) and quadratic (P2) modified Legendre polynomials were computed from each cows stage of lactation (days in milk), at the day of SF 6 methane measurement. The calibration model was developed using a modified partial least-squares regression on first derivative MIR data points · P0, first derivative MIR data points · P1, and first derivative MIR data points · P2 as variables. The MIR-predicted methane emissions (g/day) showed a calibration coefficient of determination of 0.74, a cross-validation coefficient of determination of 0.70 and a standard error of calibration of 66 g/day. When applied to milk MIR spectra recorded in the Walloon Region of Belgium (%2 000 000 records), this equation was useful to study lactational, annual, seasonal, and regional methane emissions. We conclude that milk MIR spectra has potential to be used to conduct high throughput screening of lactating dairy cattle for methane emissions. The data generated enable monitoring of methane emissions and production characteristics across and within herds. Milk MIR spectra could now be used for widespread screening of dairy herds in order to develop management and genetic selection tools to reduce methane emissions.

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