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Summary Administration of low dose dopaminePatients undergoing orthotopic liver transvasoconstriction, which mainly affects the afplantation may devclop impaired renal function ferent glomerular arterioles, with a fall in renal during the operation or in the early postblood flow and consequent renal ischaemia. operative period and occasionally require haemoSepticaemia and the use of potentially neph rodialysis. This may be due to several interacting toxic drugs, such as cephalosporins or aminofactors, of which major blood loss occurring in glycoside antibiotics (especially in combination the peri-operative period appears to be the most with loop diuretics) and the immunosuppressant important. Haemorrhage results in sympathetic cyclosporin A, may also bc causally implica1.ed.

Although patients with primary carcinoma of the liver are better operative risks, the incidence of recurrent growth is about 60%. Patients with non-malignant cirrhotic disease are more apt to develop perioperative complications, but having survived the first few weeks their chances of long-term rehabilitation are better than are those of patients with malignant conditions. Many of the earlier patients in this series would now be considered too ill for the procedure, but still about half of the patients accepted for grafting die before a donor liver becomes available, and some patients who are suitable when first seen are gravely ill by the time a liver graft can be performed.We

The circulatory response to the injection of 0.6 mg atropine during nitrous oxide, oxygen and halothane anaesthesia was studied in fifteen patients. Cardiac output was measured by the dye-dilution method and blood pressure and heart rate by manual methods. There was an immediate mean increase in heart rate from 61 to 110 beats/ min, accompanied by a 48 per cent increase in cardiac output and a 24 per cent increase in mean arterial pressure. Stroke volume fell by 17 per cent and peripheral resistance by 17 per cent. These changes were of shorter duration than the change in heart rate. No change was observed in left ventricular stroke work or "central" blood volume. Three patients developed transient arrhythmias after the injection of atropine.

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