The 2006 Consensus Guidelines reflect recent data from large clinical trials and advances in technology and are designed to assist clinicians of all subspecialties.

Transmission of hepatitis B infection from hepatitis B surface antigen (HBsAg)-negative antibody to hepatitis B core (anti-HBc)-positive liver donors has been previously described. The long-term outcome of these transplant-associated de novo hepatitis B patients has not been well described and may affect future use of donor organs that are anti-HBc-positive. We describe the experience in our first 332 transplants, performed before exclusion of anti-HBc-positive liver donors. Nine of these 332 (3%) donors were anti-HBc positive. Three of these 9 (33%) recipients developed transplant-associated de novo hepatitis B infections compared with only 2 of 323 (0.5%) recipients who received anti-HBc-negative donor livers (P = .00014). Of our 9 recipients of anti-HBc-positive livers, 6 (67%) are alive, and no deaths or allograft failures have been related to complications of hepatitis B. Only 1 of 5 patients (20%) with de novo hepatitis B has developed significant graft dysfunction with an average follow-up of more than 7 years (range 63-124 months). The 1 recipient with allograft dysfunction related to de novo hepatitis B has significantly elevated viremia levels (average HBV DNA 460 pg/mL) compared with the other de novo hepatitis B recipients (average HBV DNA 23-58 pg/mL). In summary, anti-HBc-positive donors are more likely to transmit hepatitis B infections to recipients, but these de novo infections usually have a mild clinical course and do not seem to adversely affect long-term patient survival. Hepatitis B-related allograft dysfunction, when it occurs, is associated with higher levels of viral replication. With our current donor shortage, perhaps anti-HBc-positive donors could be used in very selected recipient populations.

Physical, chemical, sensory and processing properties of milk produced by feeding a rumen-undegradable fish meal protein supplement to Holstein cows were investigated. The supplement contained (as fed basis) 25% soft-white wheat, 60% herring meal, and 15% feather meal. The total fat level in the milk decreased to 2.43%. For both pasteurized and ultra-high temperature processed drinking milk, no difference was found between fish meal (FM) milk and control milk in terms of color, flavor and flavor stability; in particular, no oxidized flavor was observed. Cheddar cheese made from FM milk ripened faster after 3 mo of ripening and developed a more desirable texture and stronger Cheddar flavor. The yield efficiencies for FM and control cheese, 94.4 (+/- 2.44 SE) and 96.4 (+/- 2.26 SE), respectively, were not different. Relative to controls, average fat globule size was smaller in FM milk and churning time of FM cream was longer. FM butter had softer texture and better cold spreadability, and butter oils from FM enriched milk had lower dropping points compared to control butter oil (average 32.89 versus 34.06 degrees C). These differences in physical properties of butter fat were greater than expected considering that iodine values were not different. This study demonstrates the feasibility of producing high quality products from milk naturally supplemented with FM, but the results also show that dietary changes affect processing properties.

An experiment was designed to determine the response of milk protein production and N utilization in dairy cows to supplementation of a predominantly rumen-undegradable protein (RUP) mixture with a fixed amino acid (AA) pattern and the response to the amount of feed intake. The experiment was designed as a 6 x 6 Latin square with a 3 x 2 factorial arrangement of treatments. The factors were three concentrations of RUP supplement (4.5, 14.9, and 29.1% of dry matter intake) and two levels of feed intake restriction (10 and 20%) of the basal diet. The supplement was designed to approximate a postruminal AA pattern that was similar to bovine caseins for Met, Lys, Phe, His, and Thr. Measurements were made during the last 5 d of each 21-d period. Milk protein production responded linearly as the concentration of RUP supplement in the treatment diet increased within the given range. The difference in feed intake restriction did not affect milk protein production. Efficiency of N utilization for milk production exceeded 30% for cows fed the lowest RUP supplement. Results indicated that there is an opportunity to increase milk protein production by using RUP formulations that are balanced for AA while minimizing waste N excretion.

The objective of this study was to determine the effect of enhanced whole-milk (WM) feeding systems in calves from birth to 8wk of age on subsequent first-lactation performance. The experiment was conducted as a completely randomized design consisting of 2 treatment groups. At birth, 152 Holstein heifer calves were randomly assigned to 1 of 2 treatments: (i) 4L of WM/d or (ii) 8L of WM/d. The calves were bucket fed 2 or 4L of WM twice daily at 0700 and 1600h. Each calf was housed individually in temperature-controlled nurseries and had ad libitum access to water and textured calf starter daily. Calves consumed greater volumes of textured calf starter when fed 4 versus 8L of WM/d. Water intakes mirrored starter intakes, leading to greater water consumption at weaning. Calves reared on 8L of WM/d were heavier at d 56 than calves reared on 4L of WM/d. The average daily gain of the calves offered 8L of WM/d from d 0 to 56 was greater than that of calves offered 4L of WM/d. Structural measurements were significantly greater for calves that consumed 8L of WM/d. The differences observed in withers height and live BW due to WM feeding level were not apparent by 3 and 12mo of age, respectively. Rumen pH was higher in calves that consumed 8L of WM/d than in calves that consumed 4L of WM/d. Whole-milk feeding level did not affect age at first calving or milk-production parameters. These results suggest that enhanced WM feeding improved growth performance until 3mo of age. However, first-lactation results indicated no lactation-performance benefits of increased nutrition and growth performance during the milk-fed period in dairy calves.