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Fourteen porcine hepatic allografts were done using techniques designed for minimal damage to the allograft. Successful transplantation was achieved in ten; technical faults caused the four failures. Hepatocellular damage reflected by elevated SGOT levels became evident during perfusion and developed slowly after revascularization. Similar changes in lactic dehydrogenase (LDH) levels were not found. Potassium efflux during cold perfusion appeared to be related not to damage, but to reversible changes in membrane potential and enzyme activity induced by hypothermia. Interference with hepatic synthesis of plasma proteins and cholesterol was observed. The depression of cholesterol levels was short-lived in comparison with that of plasma protein.

Venous thrombosis continues to represent a troublesome and even fatal complication of a variety of medical and surgical disorders. Numerous methods of treatment have been employed in both the prevention and the management of this condition, but it is generally agreed that much yet remains to be done in the satisfactory solution of this difficult problem. In the recent past direct thrombectomy has been advocated for acute and chronic venous occlusion. This has been employed in the femoral and iliac vessels particularly, and encouraging results have been reported by several observers. 1,2 In the present study an attempt has been made to devise a reliable method for the production of experimental thrombosis in large veins and to follow the natural history of such lesions with an investigation of the results following thrombectomy. Methods Twelve mongrel dogs (10-20 Kg.) were employed. Following premedication with morphine (1.25 mg. per kilogram) and chlorpromazine

A technique for orthotopic liver transplantation was used in 13 pigs, with 9 survivors. It incorporated rapid hepatic cooling at the time of donor death, continuous perfusion of the liver during hepatectomy and transplantation, rewarming of the allograft with oxygenated solution before revascularization with arterial blood shunted to the portal vein, early reestablishment of inferior vena caval flow and completion, and securing and release of each of the vascular anastomoses in turn. By these maneuvers the allograft was maintained cold and oxygenated for the entire ischemic interval, the anhepatic interval for the recipient and ischemic interval for the allograft were reduced, hypotension at the time of revascularization was prevented, and the threat of serious blood loss when multiple anastomoses are released simulatneously was eliminated.

Efficient preservation of the donor liver during hepatic transplantation is of crucial importance. Good function of the liver is required immediately after transfer if the patient is to survive liver excision and replacement, because there is no effective means of support in the absence of hepatic function. With auxiliary liver transplantation good function is again required at an early time to reverse the effects of advanced liver failure. Nevertheless, in this situation, the recipient's own liver may retain sufficient function in the early postoperative period to allow the allograft to recover from temporary damage which occurs at the time of transplantation. Laboratory experiments in dogs have shown that at normothermia the ischemic liver becomes unsuitable for transplantation after 20 to 30 minutes.1If the donor is cooled to 30 C before death and the liver perfused from the time of death with cooled electrolyte solution, this time may be

SINCE description of arteriovenous anastomosis at the wrist as a means of providing subcutaneous arterialized veins which are easily used for repeated hemodialysis (Brescia et al 1 ), this operation has been undertaken in many centers. When technically successfully, advantages are freedom from infection, hemorrhage, and thrombosis, complications which are frequent with external arteriovenous shunts. In patients with well-developed subscutaneous forearm veins, side-to-side anastomosis with the radial artery is not difficult. However, in patients with small veins, and especially in women, there is a significant risk of failure due to thrombotic occlusion within the vein. Our experience with repeated hemodialysis in 50 patients in whom arteriovenous fistulas have been created will be reported. The purpose of this paper is to describe a technique which has allowed success in eight of nine consecutive operations in women with small veins. Operative Procedure Brachial plexus block anesthesia is preferred, as this inhibits spasm of