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• Four female patients with severe complications of polycystic liver disease were treated with liver replacement; two patients were also given kidneys from their liver donors. All four of the patients were suffering from extreme fatigue. Three of the recipients have survived for 8, 11, and 60 months with normal liver function and present good health. The fourth patient recovered from a liver-kidney transplantation, but 5 months later, fulminant hepatic failure developed in this patient due to hepatitis B virus, and she died despite emergency hepatic retransplantation. ( Arch Surg . 1990;125:575-577)

• Mycotic aneurysm at the site of a Carrel patch arterial anastomosis occurred in four patients who had undergone whole pancreas transplantation 2.5 to 14.5 months previously. In all patients, the graft had been removed, leaving the Carrel patch on the iliac artery. The aneurysms ruptured into the intestine or the extraperitoneal space. The ruptures were sudden and life-threatening in three of four cases. This diagnosis must be suspected in patients with a history of pancreas transplantation in the immediate or distant past if they present with unexplained hypotension, cardiac arrest, or gastrointestinal tract bleeding. ( Arch Surg . 1989;124:660-661)

The surgical unit at St Thomas's Hospital, London, under the direction of J. B. Kinmonth, has been an international referral center for the study and management of diseases of the lymph and chyle systems for over 30 years. The unique clinical experience of this surgical center is presented in this lavishly illustrated second edition. Surgeons N. L. Browse, J. M. Edwards, and B. T. Jackson and radiologist J. S. MacDonald have also contributed to the book. The first chapter details lymphangiography methods and will mainly interest those who perform these diagnostic procedures. Chapters 2 through 5 review the normal regional anatomy of the lymphatic system. The illustrations are of exceptional quality and constitute the finest atlas available on the subject. It was disappointing, therefore, to find that the discussion of the physiology of tissue fluids and lymphatics in chapter 6 was brief and superficial. The remainder of the book deals

This book is a timely and expertly written text that emphasizes the often neglected relationship between disorders of veins and arteries and disorders of blood coagulation. In the first chapter on the pathophysiology of blood coagulation, the authors emphasize the overall scheme of coagulation mechanisms rather than the laborious details. Included is an excellent algorithm for the evaluation of tests of hemostasis. Enhanced coagulability and inappropriate thrombosis receive succinct and pertinent coverage in the second chapter. Together these chapters provide the pathophysiologic framework for the rest of the book. The second and main section of the book consists of eight chapters devoted to deep venous occlusive disease of the upper and lower extremities, pulmonary embolism, stroke, ischemic heart disease, mesenteric vascular occlusion, hepatic vein occlusion, and peripheral arterial disease. Overall, these are concise, well-organized, and extensively referenced chapters. The chapter on peripheral arterial disease, by Rich and Collins, suffers from