Hypothesis: Live donor adult liver transplantation (LDALT) is a safe and efficacious treatment for patients with end-stage liver disease.Design: Case-control study.Setting: Hepatobiliary surgery and liver transplantation unit.Patients: From December 10, 1998, through April 10, 2000, a single team performed 15 LDALT procedures with 2 simultaneous living donor kidney transplants. During this period, 66 potential donors were screened and evaluated.Interventions: Potential donors were evaluated with 3-dimensional helical computed tomographic scan, including volume renderings for hepatic lobar volume, vascular anatomy, virtual resection planes, and morphologic features. Suitable donors undergo complete medical and psychiatric evaluation and preoperative arteriography.Main Outcome Measures: Donor demographics, evaluation data, operative data, hospital length of stay, and morbidity.Results: A total of 38 men (58%) and 28 women (42%) were evaluated with 15 donors participating in LDALT. Two additional donors provided kidney grafts for simultaneous transplantation at the time of LDALT. Thirtytwo donors (48%) were rejected for either donor or recipient reasons, and 10 patients (15%) elected not to participate after initial screening. Three-dimensional volume renderings by helical computed tomographic scan predicted right lobe liver volume within 92% of actual graft volume. Donor morbidity, including all complications, was 67% with no mortality. Residual liver regenerated to approximately 70% of initial volume within 1 week and 80% within 1 month after surgery.Conclusions: Donor evaluation is an important component of LDALT. Significant donor morbidity is encountered even with careful selection. To minimize donor morbidity, groups considering initiating living donor programs should have expertise in hepatic resection and vena cava preservation using the "piggyback" technique during liver transplantation.

Life-threatening hypophosphatemia (phosphorus < 1.0 mg/dL) has been reported only once after liver resection for tumor and was associated with a significant increase in postoperative complications. Hypophosphatemia is associated with reversible cardiac dysfunction, hypoventilation, and impaired immunity. The purpose of this study was to determine the incidence of hypophosphatemia after elective right hepatic lobectomy for live donor adult liver transplantation (

Donor right hepatic lobectomy for the purpose of living liver transplantation may be associated with postoperative abnormalities in tests of clotting function. This study explores the possible causes and anesthetic implications of this phenomenon.

The National Science Digital Library (NSDL), launched in December 2002, is emerging as a center of innovation in digital libraries as applied to education. As a part of this extensive project, the GetSmart system was created to apply knowledge management techniques in a learning environment. The design of the system is based on an analysis of learning theory and the information search process. Its key notion is the integration of search tools and curriculum support with concept mapping. More than 100 students at the University of Arizona and Virginia Tech used the system in the fall of 2002. A database of more than one thousand student-prepared concept maps has been collected with more than forty thousand relationships expressed in semantic, graphical, node-link representations. Preliminary analysis of the collected data is revealing interesting knowledge representation patterns.

Medical professionals and researchers need information from reputable sources to accomplish their work. Unfortunately, the Web has a large number of documents that are irrelevant to their work, even those documents that purport to be "medically-related." This paper describes an architecture designed to integrate advanced searching and indexing algorithms, an automatic thesaurus, or "concept space," and Kohonen-based Self-Organizing Map (SOM) technologies to provide searchers with finegrained results. Initial results indicate that these systems provide complementary retrieval functionalities. HelpfulMed not only allows users to search Web pages and other online databases, but also allows them to build searches through the use of an automatic thesaurus and browse a graphical display of medical-related topics. Evaluation results for each of the different components are included. Our spidering algorithm outperformed both breadth-first search and PageRank spiders on a test collection of 100,000 Web pages. The automatically generated thesaurus performed as well as both MeSH and UMLS-systems which require human mediation for currency. Lastly, a variant of the Kohonen SOM was comparable to MeSH terms in perceived cluster precision and significantly better at perceived cluster recall.