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Rejection of a liver transplant is a rare but serious event which can be life threatening. T-cells were supposed to be the major, if not the only key player in allograft rejection. However, during recent years B-cell function has regained attention. A chimeric monoclonal antibody against CD20 protein (rituximab) successfully reversed a multi-drug resistant rejection in a liver transplant recipient. Following an uncomplicated postoperative course, the patient showed biopsy-confirmed acute rejection on postoperative day 28. Despite treatment with steroids, increased tacrolimus doses and anti-thymocyte globulin (ATG) the rejection could not be resolved. Repeated biopsies confirmed ongoing acute cellular rejection; however, a humoral component of rejection could not be fully excluded and rituximab treatment was initiated. Liver function showed a subsequent melioration accompanied by convalescence of the patient. No adverse side effects associated to rituximab administration were observed. Promising results with rituximab were reported for heart and kidney transplant recipients suffering from humoral rejection. To our knowledge this is the first report of a successful rescue therapy of a multi-drug-resistant liver allograft rejection with rituximab. The addition of rituximab might be a valuable option to overcome severe, multi-drug-resistant rejection, although humoral nature of rejection is not proven by histology.

PurposeTo report on the content management system designed to manage the 30 web‐based research guides developed by the subject liaison librarians at the Georgia State University Library.Design/methodology/approachThe web development librarian, with assistance from the web programmer, designed a system using MySQL and ASP. A liaison team gave input on the system through rigorous testing and assisted with the design of the templates that control the layout of the content on the guides. A usability study and two surveys were also completed.FindingsThe new system met and exceeded the baseline expectations for content collection and management, offering a greater control over appearance and navigation while still offering customization features for liaisons. Improvements are planned for the templates in addition to better promotion of the guides on the library web site. Initial and ongoing training for the liaisons should have been more effectively addressed. Despite their observed and future potential advantages, the CMS model has not been universally adopted by academic libraries.Practical implicationsRegardless of the technology involved, libraries preparing for a CMS transition must give at least as much attention to user issues as they do to technical issues, from the organizational buy‐in and comprehensive training to internal/external usability.Originality/valueThis paper contributes to a small but growing collection of CMS case studies. It covers the technical, functional, and managerial developments of a CMS, while also addressing the practical user factors that sometimes get lost in the process.

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