All incubations were performed for 30 minutes at room temperature

and followed by a wash in three changes of PBS for 5 minutes. For all immunohistochemical stainings, 3-amino-9-ethylcarbazol (AEC) in 0.01% H2O2 was used as substrate-chromogen. The sections were counterstained with hematoxylin. Negative controls consisted of omission of the primary antibody and were consistently negative. To ensure uniform handling of samples, all sections were processed simultaneously. All immunohistochemically stained slides were evaluated for staining Ibrutinib cost patterns and intensities by four observers (T.R., Y.V., J.W., and L.L.). Histological changes, i.e., portal inflammation; hepatocellular, canalicular, and ductular bilirubinostasis; ductular reaction; steatosis and centrolobular necrosis were graded using a semiquantitative scoring system. BA transporter expression was semiquantitatively graded as compared with what was deemed normal by the pathologist. For the assessment of NRs, intensity of nuclear localized staining was scored. Statistical analysis was performed using Statview 5.0.1 (SAS Institute, Cary, NC). All quantitative

values were assessed for normality. Values with normal distribution, and those that were normalized after logarithmic transformation, are represented as mean ± standard error of the mean (SEM) and were compared using the unpaired Student’s t test. The nonnormally distributed data were represented as medians and interquartile range (IQR) (1st-3rd) and compared by the nonparametric Mann-Whitney U test. Nominal JNK inhibitors high throughput screening and ordinal variables (expressed as numbers and percentages) were compared by Fisher’s exact test. Correlations between variables were calculated using either Pearson’s or Spearman’s rank correlation test. For all comparisons P < 0.05 was deemed significant.

Baseline characteristics of ICU (n = 130) and control (n = 20) patients are described in Table 1. The total ICU population, as well as the subset used for immunohistochemical analysis, was matched with control patients for gender, age, and body mass index (Supporting Data Table 1). Serum total bilirubin on the last day of ICU stay was 8-fold higher in ICU patients than in controls (Table 1) and the hyperbilirubinemia was predominantly conjugated. Compared click here with controls, serum ALP and GGT levels in ICU patients were 1.6- and 3-fold higher, respectively (Table 1). In parallel, serum total BAs were 11-fold higher (P < 0.0001) in ICU patients (Table 1), this increase being mainly attributable to conjugated BAs (Table 2). There was no effect of tight glycemic control on circulating bilirubin or BA levels. There was an increase in conjugation percentage for the primary BA cholic acid (CA) (98.3% in patients versus 55.6% in controls) and chenodeoxycholic acid (CDCA) (95.9% in patients versus 37.

All incubations were performed for 30 minutes at room temperature

and followed by a wash in three changes of PBS for 5 minutes. For all immunohistochemical stainings, 3-amino-9-ethylcarbazol (AEC) in 0.01% H2O2 was used as substrate-chromogen. The sections were counterstained with hematoxylin. Negative controls consisted of omission of the primary antibody and were consistently negative. To ensure uniform handling of samples, all sections were processed simultaneously. All immunohistochemically stained slides were evaluated for staining find more patterns and intensities by four observers (T.R., Y.V., J.W., and L.L.). Histological changes, i.e., portal inflammation; hepatocellular, canalicular, and ductular bilirubinostasis; ductular reaction; steatosis and centrolobular necrosis were graded using a semiquantitative scoring system. BA transporter expression was semiquantitatively graded as compared with what was deemed normal by the pathologist. For the assessment of NRs, intensity of nuclear localized staining was scored. Statistical analysis was performed using Statview 5.0.1 (SAS Institute, Cary, NC). All quantitative

values were assessed for normality. Values with normal distribution, and those that were normalized after logarithmic transformation, are represented as mean ± standard error of the mean (SEM) and were compared using the unpaired Student’s t test. The nonnormally distributed data were represented as medians and interquartile range (IQR) (1st-3rd) and compared by the nonparametric Mann-Whitney U test. Nominal http://www.selleckchem.com/products/Tipifarnib(R115777).html and ordinal variables (expressed as numbers and percentages) were compared by Fisher’s exact test. Correlations between variables were calculated using either Pearson’s or Spearman’s rank correlation test. For all comparisons P < 0.05 was deemed significant.

Baseline characteristics of ICU (n = 130) and control (n = 20) patients are described in Table 1. The total ICU population, as well as the subset used for immunohistochemical analysis, was matched with control patients for gender, age, and body mass index (Supporting Data Table 1). Serum total bilirubin on the last day of ICU stay was 8-fold higher in ICU patients than in controls (Table 1) and the hyperbilirubinemia was predominantly conjugated. Compared this website with controls, serum ALP and GGT levels in ICU patients were 1.6- and 3-fold higher, respectively (Table 1). In parallel, serum total BAs were 11-fold higher (P < 0.0001) in ICU patients (Table 1), this increase being mainly attributable to conjugated BAs (Table 2). There was no effect of tight glycemic control on circulating bilirubin or BA levels. There was an increase in conjugation percentage for the primary BA cholic acid (CA) (98.3% in patients versus 55.6% in controls) and chenodeoxycholic acid (CDCA) (95.9% in patients versus 37.

The reduced-expression

of E-CAD and over-expression of MMP-7 may be important promoting factors in invasion and metastasis of colorectal carcinoma. They may be valuable indicators for diagnosing in early colorectal carcinoma, selecting therapy and assessing prognosis. Key Word(s): 1. Colorectal carcinoma; 2. Immunohistochemistry; 3. E-cadherin; 4. Matrix m-7; Presenting LGK-974 ic50 Author: CHENYING YING Corresponding Author: CHENYING YING Affiliations: First Affiliated Hospital of Harbin Medical University Objective: To investigate the gene polymorphisms of interferon-γ(IFN-γin patients with ulcerative colitis(UC), as well as the relationship of UC pathogenesy and gene polymorphism. Methods: The cytokine genotypes of IFN-γfrom UC(n = 56) and normal persons(n = 44) were detected by Sequence- Specific Primers polymerase chain reaction (PCR-SSP). And the serum levels of cytokines were assayed by ELISA. Results: The genotype frequency and allelic frequency of IFN-γ+874 in UC patients had no significant difference compared with that in normal control cases (P > 0.05). Each genotype frequency of IFN-γ+874 had no significant difference among UC with three regionals (P > 0.05). The level of serum IFN-γin active UC was much higher

than that in catabolic UC and control group (P < 0.05). There were no significantly difference of IFN-γamong different genotypes in UC groups. (P > 0.05). Conclusion: The polymorphisms of IFN-γ+874 may have no influence on RNA Synthesis inhibitor the susceptibility to UC. Genotypes may be the determinants click here of their corresponding serum levels in healthy adult people, however, the serum levels in UC patients were also influenced by other

factors simultaneously. Key Word(s): 1. interferon-γ; 2. Ulcerative colitis; 3. Gene polymorphisms; Presenting Author: JIANG MIAO Corresponding Author: JIANG MIAO Affiliations: The First Affiliated Hospital of Harbin Medical University Objective: To study the apoptosis effect of Arsenic trioxideon on human gastric and colorectal adenocarcinoma cells and mechanisms and the relation between this apoptosis and expression of p53 and bcl -2. Methods: Intravenous administration of Arsenic trioxideon at 10 mg/ day for 3 days were carried out preoperatively. The expression of p53, bcl-2 and apoptosis induced by arsenic trioxide were examined by immunohistochemistry method and TUNEL. Results: Arsenic trioxide induced decrease of the expression of bcl -2 and increase of the expression of apoptosis in gastric and colorectal cancer cells. The expression of p53 was not changed by As2O3. Conclusion: Preoperatively intravenous chemotherapy with Arsenic trioxide can induce apoptosis and inhibite proliferation effectively in gastric and colorectal cancer. Arsenic trioxide induce the apoptosis of gastric and colorectal cancer cells through accommodating the expression of cancer associated genes. Key Word(s): 1. Arsenic trioxide; 2.

The reduced-expression

of E-CAD and over-expression of MMP-7 may be important promoting factors in invasion and metastasis of colorectal carcinoma. They may be valuable indicators for diagnosing in early colorectal carcinoma, selecting therapy and assessing prognosis. Key Word(s): 1. Colorectal carcinoma; 2. Immunohistochemistry; 3. E-cadherin; 4. Matrix m-7; Presenting check details Author: CHENYING YING Corresponding Author: CHENYING YING Affiliations: First Affiliated Hospital of Harbin Medical University Objective: To investigate the gene polymorphisms of interferon-γ(IFN-γin patients with ulcerative colitis(UC), as well as the relationship of UC pathogenesy and gene polymorphism. Methods: The cytokine genotypes of IFN-γfrom UC(n = 56) and normal persons(n = 44) were detected by Sequence- Specific Primers polymerase chain reaction (PCR-SSP). And the serum levels of cytokines were assayed by ELISA. Results: The genotype frequency and allelic frequency of IFN-γ+874 in UC patients had no significant difference compared with that in normal control cases (P > 0.05). Each genotype frequency of IFN-γ+874 had no significant difference among UC with three regionals (P > 0.05). The level of serum IFN-γin active UC was much higher

than that in catabolic UC and control group (P < 0.05). There were no significantly difference of IFN-γamong different genotypes in UC groups. (P > 0.05). Conclusion: The polymorphisms of IFN-γ+874 may have no influence on learn more the susceptibility to UC. Genotypes may be the determinants click here of their corresponding serum levels in healthy adult people, however, the serum levels in UC patients were also influenced by other

factors simultaneously. Key Word(s): 1. interferon-γ; 2. Ulcerative colitis; 3. Gene polymorphisms; Presenting Author: JIANG MIAO Corresponding Author: JIANG MIAO Affiliations: The First Affiliated Hospital of Harbin Medical University Objective: To study the apoptosis effect of Arsenic trioxideon on human gastric and colorectal adenocarcinoma cells and mechanisms and the relation between this apoptosis and expression of p53 and bcl -2. Methods: Intravenous administration of Arsenic trioxideon at 10 mg/ day for 3 days were carried out preoperatively. The expression of p53, bcl-2 and apoptosis induced by arsenic trioxide were examined by immunohistochemistry method and TUNEL. Results: Arsenic trioxide induced decrease of the expression of bcl -2 and increase of the expression of apoptosis in gastric and colorectal cancer cells. The expression of p53 was not changed by As2O3. Conclusion: Preoperatively intravenous chemotherapy with Arsenic trioxide can induce apoptosis and inhibite proliferation effectively in gastric and colorectal cancer. Arsenic trioxide induce the apoptosis of gastric and colorectal cancer cells through accommodating the expression of cancer associated genes. Key Word(s): 1. Arsenic trioxide; 2.

to take it into account in their review. Second, performance of noninvasive methods is certainly good for diagnosing cirrhosis but poor for significant fibrosis; the Fibrostic study did not even reach the minimum values of 85% sensitivity and specificity deemed high enough by Martínez et al. Moreover, the Fibrostic study results showed the ability of noninvasive tests to confirm or rule out significant fibrosis was satisfactory in limited ranges of high or low values only.3 Third, accuracy is

only a step toward a possible usefulness of a test.5 As rightly stressed click here by Martínez et al. at the end of their article, the improvement of patient outcomes is more relevant. However, the prediction

of clinical endpoints by noninvasive methods was only recently investigated by very few studies, and to our knowledge, no study assessed their ability to predict response to therapy. We all wish that noninvasive methods could allow us to avoid liver biopsy while ensuring that patients will be managed as well or better than with old techniques. Therefore, studies are needed in order to specify their contribution to the choice of patient management for improving clinical endpoints or treatment response. Françoise Degos M.D., Ph.D.*, Louis Lebrun M.D.†, Paul Perez M.D., Ph.D.‡, Isabelle Durand-Zaleski M.D.†, * Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Beaujon, Hepatology Department, Institut National de la Santé et de la Recherche Médicale Unité 773, Clichy, France, † AP-HP, DRCD-URC Eco, Paris, CHIR-99021 ic50 France, ‡ Centre Hospitalier Universitaire de Bordeaux, Clinical Epidemiology Unit and CIC-EC7, Bordeaux, France. “
“Hepatitis C virus (HCV) is

a commonly transmitted infection that has both hepatic and extrahepatic repercussions. These range from the inflammatory to the oncologic with an undisputed link to hepatitis, liver cirrhosis, and hepatocellular carcinoma. Its role in the development of B cell non-Hodgkin lymphoma (B-NHL) is becoming better understood, selleck inhibitor leading to opportunities for research, therapy, and even prevention. Research in the field has progressed significantly over the last decade, with the number of patients diagnosed with HCV and B-NHL rising incrementally. It is therefore becoming crucial to fully understand the pathobiologic link of HCV in B cell lymphomagenesis and its optimal management in the oncologic setting. (HEPATOLOGY 2012) Over 180 million people are infected with hepatitis C virus (HCV), accounting for 3% of the global population.1 HCV is well-recognized as a cause of hepatic disease and hepatocellular carcinoma, while its hematologic manifestations (mixed cryoglobulinemia [MC] and B cell non-Hodgkin lymphoma [B-NHL]) are less appreciated.

to take it into account in their review. Second, performance of noninvasive methods is certainly good for diagnosing cirrhosis but poor for significant fibrosis; the Fibrostic study did not even reach the minimum values of 85% sensitivity and specificity deemed high enough by Martínez et al. Moreover, the Fibrostic study results showed the ability of noninvasive tests to confirm or rule out significant fibrosis was satisfactory in limited ranges of high or low values only.3 Third, accuracy is

only a step toward a possible usefulness of a test.5 As rightly stressed Wnt pathway by Martínez et al. at the end of their article, the improvement of patient outcomes is more relevant. However, the prediction

of clinical endpoints by noninvasive methods was only recently investigated by very few studies, and to our knowledge, no study assessed their ability to predict response to therapy. We all wish that noninvasive methods could allow us to avoid liver biopsy while ensuring that patients will be managed as well or better than with old techniques. Therefore, studies are needed in order to specify their contribution to the choice of patient management for improving clinical endpoints or treatment response. Françoise Degos M.D., Ph.D.*, Louis Lebrun M.D.†, Paul Perez M.D., Ph.D.‡, Isabelle Durand-Zaleski M.D.†, * Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Beaujon, Hepatology Department, Institut National de la Santé et de la Recherche Médicale Unité 773, Clichy, France, † AP-HP, DRCD-URC Eco, Paris, ITF2357 France, ‡ Centre Hospitalier Universitaire de Bordeaux, Clinical Epidemiology Unit and CIC-EC7, Bordeaux, France. “
“Hepatitis C virus (HCV) is

a commonly transmitted infection that has both hepatic and extrahepatic repercussions. These range from the inflammatory to the oncologic with an undisputed link to hepatitis, liver cirrhosis, and hepatocellular carcinoma. Its role in the development of B cell non-Hodgkin lymphoma (B-NHL) is becoming better understood, this website leading to opportunities for research, therapy, and even prevention. Research in the field has progressed significantly over the last decade, with the number of patients diagnosed with HCV and B-NHL rising incrementally. It is therefore becoming crucial to fully understand the pathobiologic link of HCV in B cell lymphomagenesis and its optimal management in the oncologic setting. (HEPATOLOGY 2012) Over 180 million people are infected with hepatitis C virus (HCV), accounting for 3% of the global population.1 HCV is well-recognized as a cause of hepatic disease and hepatocellular carcinoma, while its hematologic manifestations (mixed cryoglobulinemia [MC] and B cell non-Hodgkin lymphoma [B-NHL]) are less appreciated.

It is bound to bring about a fundamental change in human health and life span, and contribute to a full-scale medical revolution. Key Word(s): 1. general; 2. medical psychology; Presenting Author: 苏 Additional Authors: 李 爽, 孔 祥民, 傅 Corresponding Author: 苏 Affiliations: Objective: To

investigate the impact of gastrointestinal motility drug on the gastric transit time, complete small bowel transit time in capsule endoscopy. Methods: Collected 60 cases of patients in small bowel capsule endoscopy in our hospital from October 2011 to October 2012, divided into three groups evenly, Group A: Oral domperidone 10 mg10 minutes before the examination; Group B: oral mosapride 10 mg 10 minutes before the examination; Z-IETD-FMK supplier Group C: did not take any click here medication before the examination. Results: Group A average gastric transit time of the capsule was 24 min ± 15 min, Group B average gastric transit time was 27 min ± 20 min, Group C average gastric transit time was 45 min ± 33 min. Domperidone, mosapride can shorten the residence time of the capsule in the stomach (p < 0.05); Group A average small bowel transit

time of the capsule was 6 h ± 1 h 50 min, Group B average small bowel transit time was 3 h 40 min ± 2 h 11 min, Group C average small bowel transit time was 6 h 30 min ± 2 h 12 min., Group B compared with Group A, Group B compared with Group C, the differences were statistically significant (P < 0.05); Group A compared with Group C, the difference was not statistically significant (P > 0.05). Conclusion: Prior to capsule endoscopy the oral gastrointestinal drugs can shorten selleck inhibitor the residence time of the capsule in the stomach; oral mosapride before capsule endoscopy can shorten the time the capsule went through the small bowel. Key Word(s): 1. domperidone; 2. mosapride; 3. capsule endoscopy; 4. shorten time; Presenting Author: SUDARSHAN KAPOOR Additional Authors: BALDEV SINGH

Corresponding Author: SUDARSHAN KAPOOR Affiliations: GOVT.MEDICAL COLLEGE, AMRITSAR, INDIA Objective: Intestinal anastomosis is a surgical procedure to establish communication between two formerly distant portions of the intestine. This procedure restores intestinal continuity after removal of a pathological condition affecting the bowel. Intestinal anastomosis is one of the most commonly performed surgical procedures, especially in the emergency setting, and is also commonly performed in the elective setting when resections are carried out for benign or malignant lesions of the gastrointestinal tract. A disastrous complication of intestinal anastomosis is anastomotic leak resulting in peritonitis, which is associated with high morbidity and mortality. Proper surgical technique and adherence to fundamental principles is imperative to ensure successful outcome after intestinal anastomosis.Indications.

It is bound to bring about a fundamental change in human health and life span, and contribute to a full-scale medical revolution. Key Word(s): 1. general; 2. medical psychology; Presenting Author: 苏 Additional Authors: 李 爽, 孔 祥民, 傅 Corresponding Author: 苏 Affiliations: Objective: To

investigate the impact of gastrointestinal motility drug on the gastric transit time, complete small bowel transit time in capsule endoscopy. Methods: Collected 60 cases of patients in small bowel capsule endoscopy in our hospital from October 2011 to October 2012, divided into three groups evenly, Group A: Oral domperidone 10 mg10 minutes before the examination; Group B: oral mosapride 10 mg 10 minutes before the examination; Selleckchem BMS-777607 Group C: did not take any selleck chemical medication before the examination. Results: Group A average gastric transit time of the capsule was 24 min ± 15 min, Group B average gastric transit time was 27 min ± 20 min, Group C average gastric transit time was 45 min ± 33 min. Domperidone, mosapride can shorten the residence time of the capsule in the stomach (p < 0.05); Group A average small bowel transit

time of the capsule was 6 h ± 1 h 50 min, Group B average small bowel transit time was 3 h 40 min ± 2 h 11 min, Group C average small bowel transit time was 6 h 30 min ± 2 h 12 min., Group B compared with Group A, Group B compared with Group C, the differences were statistically significant (P < 0.05); Group A compared with Group C, the difference was not statistically significant (P > 0.05). Conclusion: Prior to capsule endoscopy the oral gastrointestinal drugs can shorten selleck compound the residence time of the capsule in the stomach; oral mosapride before capsule endoscopy can shorten the time the capsule went through the small bowel. Key Word(s): 1. domperidone; 2. mosapride; 3. capsule endoscopy; 4. shorten time; Presenting Author: SUDARSHAN KAPOOR Additional Authors: BALDEV SINGH

Corresponding Author: SUDARSHAN KAPOOR Affiliations: GOVT.MEDICAL COLLEGE, AMRITSAR, INDIA Objective: Intestinal anastomosis is a surgical procedure to establish communication between two formerly distant portions of the intestine. This procedure restores intestinal continuity after removal of a pathological condition affecting the bowel. Intestinal anastomosis is one of the most commonly performed surgical procedures, especially in the emergency setting, and is also commonly performed in the elective setting when resections are carried out for benign or malignant lesions of the gastrointestinal tract. A disastrous complication of intestinal anastomosis is anastomotic leak resulting in peritonitis, which is associated with high morbidity and mortality. Proper surgical technique and adherence to fundamental principles is imperative to ensure successful outcome after intestinal anastomosis.Indications.

Conclusion: About 9% of patients with HHT develop symptomatic liver disease. A simple scoring system using age, gender, hemoglobin and alkaline phosphatase can stratify patients into low, moderate and high risk for clinically significant liver disease. Estimated probability of clinically significant

liver disease in patients with HHT based on Simple Clinical Scoring Index. Cumulative Score using Simple Clinical Scoring Index Estimated Probability of Clinically Significant Hepatic Involvement (%) 0 0.4 1 1.2 2 3.2 3 8.2 4 19.5 5 39.7 6 64.1 7 82.9 8 93.0 Disclosures: The following people have nothing to disclose: Siddharth Singh, Karen L. Swanson, Matthew Hathcock, Walter K. Kremers, John Pallanch, Michael J. Krowka, Patrick S. Kamath Gut milieu alterations are associated with cirrhosis complications such Sirolimus concentration as hepatic encephalopathy(HE)and infections. An unfavorable learn more gut microbiome(dysbiosis) could modulate cirrhosis progression. Aim: Evaluate gut microbiota changes across the spectrum of cirrhosis. Methods: Cirrhotics and age-matched controls underwent a cross-sectional stool analysis using multitagged pyrosequencing. Microbiome abundance and cirrhosis dysbiosis ratio

(CDR); ratio of the beneficial autochthonous (Lachnospiraceae+Ruminococaceae+Veillonellaceae+Clostridiales Incertae Sedis XIV) and potentially pathogenic taxa abundance (Enterobacteriaceae+Bacteroidaceae) was compared between groups. Results: 250 cirrhotics [(206 outpatients (no HE: 139, HE: 67), infected inpatients: 44] &25 controls were included. Etiology was alcohol 20%, NASH 14%, rest HCV. MELD was highest in inpatients compared to HE & no HE pts check details (19 vs 14 vs

10, p<0.001), was negatively related to CDR & autochthonous taxa (all p<0.0001) and positively with pathogenic ones; (Staphylococcae, Enterococcaeae &Enterobacteriaceae, p<0.001). With worsening cirrhosis, there was further dysbiosis compared to controls due to autochthonous taxa reduction &pathogenic taxa overgrowth(Table). Dysbiosis (CDR 0.74 vs 0.15, p<0.001) was seen in inpatient vs outpatients. In outpatients HE pts had a significantly lower CDR compared to non-HE (p=0.04). Etiology analysis: Despite similar MELD (12 vs 13) alcoholics had a lower CDR (1.8 vs 3.9) due to lower authochthonous taxa (all p<0.001)compared to non-alcoholics. However NASH cirrhotics had similar CDR(3.8 vs 3.0) than the rest but higher Bacteroidaceae (43 vs 19%, p<0.001), PorphyromcnadaceaeM vs 1%, p=0.003), &lower Veillonellaceae (2 vs 0%, p<0.001). Conclusions: The Cirrhosis Dysbiosis Ratio quantifies the unfavorable gut microbiome that is ssociated with worsening disease severity in this large cirrhotic population. This dysbiosis could be play a role in pathogenesis and progression of cirrhosis. Significantly Different Microbiota Abundances Median % taxa abundance (all p<0.

Disclosures: The following people have nothing to disclose: Lisa B. VanWagner, Marina Serper, Raymond Kang, Anton I. Skaro, Josh Levitsky, Samuel Hohmann, Donald M. Lloyd-Jones Calcineurin inhibitors (CNI) induce chronic renal dysfunction. Switching CNI to mycofenolate mofetil (MMF) monotherapy remains controversial due to an increased risk of acute rejection. To safely withdraw CNI, mycophenolic INCB024360 acid (MPA) should be monitored. Aims: 1) Define a safe MPA targeted exposure (AUC). 2) Study the benefit and efficacy

of MMF monotherapy under therapeutic drug monitoring. Methods: 1) To define a safe MPA targeted exposure, 18 stable LT recipients previously treated with MMF monotherapy, were selected. Algorithms were used to determine AUC0-12h (0, H0.5, H2, H3 and H4). 2) Patients that required CNI withdrawal were selected, and prospectively followed. Before CNI withdrawal MMF, daily doses were adjusted to reach the MPA targeted previously

determined. Doxorubicin Data as ALT, glomerular filtration rate (GFR) using MDRD formula were prospectively collected at CNI withdrawal (baseline), M1, and each year until M72. Results: 1) A wide variability in MPA concentrations was observed at any time, with mean C0, C0.5, C2, C3 and C4 values at 2.4 (0.4 to 4.6), 15.2 (4.5 to 31.1), 5.2 (2.2 to 9.5), 3.3 (0.9 to 5.5) and 2.9 mg/L (0.6 to 5.3). For C0 MPA a greater than 10-fold range was observed. The mean estimated AUC0-12h value was 48.1 ±13 mg.h/L. MPA AUC0-12 did not correlate with MMF daily dose (r= 0.27, p=0.2). 2) From dec 2000 to dec 2013, 103 recipients (mean age 60.2±7.4 yrs) underwent MMF monotherapy after a mean of 6.3±3.9 yrs from LT. LT indication was alcoholic cirrhosis in 73% of cases, mean MPA AUC was at 49.3±17.1 and GFR was 47.8±16.9 ml/kg/ min. Follow up: 4 patients had

acute rejection and 2 required steroid bolus. Over time, patients did not have a significant change in term of: ALT (23.2±13.4 vs 25.7±16.2) click here and weight (80±18.2 to 80±19.1). Renal function improved significantly (GFR 47.7±15.7 to 53.7±19.6, p<0.001). This improvement occurred the first year of MMF monotherapy (GFR: 45.8±14.9 to 52.9±19.8 ml/kg/min; p<0.05), as shown by GFR evolution between 1 and 2 years: 50.8±17.1 vs 48.1 ±14.7 (ns), and also concerned patients with a low GFR at baseline (<60) 41.3±10 to 47.9±15.4 ml/kg/min p<0.05. GGT worsened (57.6±50.5 vs 79.6±92.5 p<0.001). Patients with elevated GGT after MMF monotherapy did not differ at baseline from other in terms of: age (60.3 vs 59.7), time after LT (6.9 vs 5.8), MPA AUC (50 vs 52) or weight (82 vs 78kg). Conclusion: In maintenance LT recipients, MMF monotherapy regimen is safe when a 45 mg.h/L AUC is targeted and improve renal function with low risk of acute rejection.