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Long-term immunoprophylaxis with anti-HBs immunoglobulins (HBIgH BV reinfection after liver transplantation for HBVrelated cirrhosis is frequent in the absence of immunoprophylaxis and is associated with poor prognosis, resulting from the development of cirrhosis, fibrosing hepatitis, or fulminant hepatitis. 1-2 The introduction of the long-term use of anti-HBs immune globulins (HBIg) has allowed the reduction of graft reinfection to acceptable levels, resulting in survival rates comparable with, or even better than, those of other indications. [3][4][5] This passive immunoprophylaxis strategy is therefore currently considered the standard treatment to prevent HBV reinfection after liver transplantation for HBV-related cirrhosis. 6 Yet, using this approach, posttransplant HBV recurrence still occurs in 10% to 30% of cases, possibly depending on a variety of factors, such as the amount of HBIg infused, the route and frequency of administration, and the minimum trough levels of anti-HBs maintained during various periods after transplant. 6 According to current recommendations, HBIg should be administered indefinitely after transplant. This is associated with a number of problems, including the limited availability of HBIg, the possible emergence of HBV envelope protein mutations, 7,8 and/or other adverse events, 9,10 and, most importantly, the extremely high costs. 6 Whatever is the prophylactic regimen used (which varies remarkably from one Center to another) and the cost differences of HBIg preparations between U.S. and most Western European countries, the expenses of post-transplant HBIg administration range between $25,000 and $120,000 per year, thus exceeding in a few years those of an uncomplicated transplant.New prophylactic strategies to prevent posttransplant HBV recurrence are therefore needed. New approaches under evaluation include the combination of lower doses of HBIg with antivirals, such as lamivudine, 11,12 and HBV vaccination, as proposed in the recent provocative study of Sanchez-Fueyo et al. 13 from Spain.

SUMMARYBackground: In patients with chronic liver disease, the measurement of liver function is critical for monitoring disease progression, predicting the prognosis and choosing therapeutic strategies. The 13 C-methacetin breath test is a simple, non-invasive diagnostic tool based on an inexpensive, non-toxic substance, which allows the accurate measurement of liver functional reserve. Aim: To investigate the 13 C-methacetin breath test as a tool to monitor hepatic function in liver transplant candidates and recipients. Methods: Twenty-eight cirrhotic patients listed for orthotopic liver transplantation and 10 healthy controls were studied. The 13 C-methacetin breath test (75 mg per os) was performed at baseline and at 12-week intervals. Intra-operative measurements were obtained during the liver transplantation procedure in nine patients. Results were expressed as the 13 C-methacetin

When laser ablation is used to treat small HCC nodules, tumor location does not have a significant negative impact on the technique's primary effectiveness or safety or on its ability to achieve local control of disease.

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