1) Recognizing that failure

1). Recognizing that failure Romidepsin molecular weight to provide the extra liver with a normal portal venous supply could handicap the allograft in the same way as the native livers were damaged in my nontransplant portal diversion models, I began the development of versatile transplant procedures to study the special qualities of splanchnic venous blood in dogs. One of the models was a method of total recipient hepatectomy, the unique feature of which was preservation of the retrohepatic inferior vena

cava2 as in the first stage of today’s piggy-back human liver transplantation. For liver allograft implantation, it was technically easier to simply remove this portion of the recipient vena cava click here and replace it with the comparable segment of the donor liver’s vena cava into which all of the hepatic veins empty.3 Operative survival with the complete canine replacement operation (Fig. 2) was not accomplished until a few days after I moved to Northwestern in June 1958 for a final 12 months of cardiovascular surgical

training that was expected to culminate in an academic practice in thoracic surgery. Instead, two steps were taken during the summer of 1958 that ensured pursuit of the liver research for at least 5 years beyond completion of the thoracic residency. The first step was the submission of a four-page NIH grant focused on metabolic studies in which liver replacement was one of the experimental models. The second step was my nomination by Northwestern for a John and Mary Markle Scholarship. Here, the emphasis was radically different. Markle Scholar candidates were expected to identify an open-ended career objective. Ignoring check details advice to develop a “more realistic” project in the emerging field of open heart surgery, I proposed the life goal of clinical liver transplantation. In the autumn of 1958, I learned

that the NIH grant would be fully funded for 5 years, and shortly thereafter that I had been selected as a Markle Scholar. The first phase of the canine liver project was nearly completed by the time I finished the thoracic residency and the dual revenue streams began on July 1, 1959. In addition, a second operation had been perfected in which the liver was transplanted as part of an allograft that contained all of the other intra-abdominal viscera (Fig. 3).6, 7 The magnitude of the Markle proposal should have been intimidating, but it did not seem so at the time. The slate of liver transplantation was nearly blank in 1958, but what had to be done was transparent: make the operation biologically sound, make it practical, and find a way to prevent allograft rejection. I was not the only person to think that way. Although I did not learn of it until a year later, Francis D.

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