***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The use of UW solution1 has result ed in improved graft function after transplantation2,3 even with long average preservation times.4 However , although the incidence of  primary nonfunction ( PNF ) has decreased , it remains a significant clinical problem , in part because the dem and for livers has caused an increased use of previously discarded organs.5 Greig et al6 have reported that prostagl and in E1 ( PGE1 ) can ameliorate , or reverse , severe ischemic injury after liver transplantation , consistent with reports of several prostagl and in agents in experimental hepatic7–11 and nonhepatic12,13 test models of ischemic injury . In addition , we have reported that the combination of PGE1 plus high-dose steroids favorably influences the course of human liver allografts transplanted despite a positive lymphocytotoxic cross match14 and that PGE1 in cross-match negative cases reduces FK 506 nephrotoxicity.15 Consequently , we began in October 1991 to give PGE1 perioperatively to all liver recipients with a subsequent very low ( 1.1 % ) incidence of PNF in 174 consecutive negative cross-match cases The shortage of suitable organs for liver grafts is responsible for the use of marginal donors for liver transplantation ( OLT ) . If these liver grafts function poorly initially after OLT , a supportive therapy is necessary . The purpose of this study was to evaluate the effects of prostacyclin ( PGI2 ) on postoperative liver graft function after OLT.A total of 30 adult recipients of primary OLT were r and omized to either receive PGI2 ( 4 ng/kg per min body weight , n=15 ) or a placebo for 6 d. To evaluate regional splanchnic oxygenation a fiberoptic pulmonary‐artery catheter was inserted into a hepatic vein and the difference between mixed venous oxygen content and hepatic venous oxygen content was determined ( ΔO2 ) . Measurements were performed directly after transplantation and at 6 , 12 , 24 and 48 h postoperatively . A significant correlation between ΔO2 and the level of transaminases ( ALT/AST ) was observed 24 and 48 h after transplantation ( p<0.05 ) . PGI2 treatment induced a significant decrease in ΔO2 after 24 and 48 h after reperfusion ( p<0.05 ) . Peak AST levels tended to be lower in the PGI2 treatment group ( 418±99 vs. 638±156 U/L , p<0.1).These results suggest that administration of PGI2 after OLT improves hepatic‐splanchnic oxygenation and may thereby reduce reperfusion injury after OLT OBJECTIVES To analyze sources search ed in Cochrane review s , to determine the proportion of trials included in review s that are indexed in major data bases , and to compare the quality of these trials with those from other sources . METHODS All new systematic review s in the Cochrane Library , Issue1 2001 , that were restricted to r and omized controlled trials ( RCTs ) or quasi- RCTs were selected . The sources search ed in the review s were recorded , and the trials included were checked to see whether they were indexed in four major data bases . Trials not indexed were checked to determine how they could be identified . The quality of trials found in major data bases was compared with those found from other sources . RESULTS The range in the number of data bases search ed per review ranged between one and twenty-seven . The proportion of the trials in the four data bases were Cochrane Controlled Trials Register = 78.5 % , MEDLINE = 68.8 % , Embase = 65.0 % , and Science/Social Sciences Citation Index = 60.7 % . Search ing another twenty-six data bases after Cochrane Controlled Trials Register ( CCTR ) , MEDLINE , and Embase only found 2.4 % additional trials . There was no significant difference between trials found in the CCTR , MEDLINE , and Embase compared with other trials , with respect to adequate allocation concealment or sample size . CONCLUSIONS There was a large variation between review s in the exhaustiveness of the literature search es . CCTR was the single best source of RCTs . Additional data base search ing retrieved only a small percentage of extra trials . Contacting authors and manufacturers to find unpublished trials appeared to be a more effective method of obtaining the additional better quality trials CONTEXT Selective reporting of outcomes within published studies based on the nature or direction of their results has been widely suspected , but direct evidence of such bias is currently limited to case reports . OBJECTIVE To study empirically the extent and nature of outcome reporting bias in a cohort of r and omized trials . DESIGN Cohort study using protocol s and published reports of r and omized trials approved by the Scientific-Ethical Committees for Copenhagen and Frederiksberg , Denmark , in 1994 - 1995 . The number and characteristics of reported and unreported trial outcomes were recorded from protocol s , journal articles , and a survey of trialists . An outcome was considered incompletely reported if insufficient data were presented in the published articles for meta- analysis . Odds ratios relating the completeness of outcome reporting to statistical significance were calculated for each trial and then pooled to provide an overall estimate of bias . Protocol s and published articles were also compared to identify discrepancies in primary outcomes . MAIN OUTCOME MEASURES Completeness of reporting of efficacy and harm outcomes and of statistically significant vs nonsignificant outcomes ; consistency between primary outcomes defined in the most recent protocol s and those defined in published articles . RESULTS One hundred two trials with 122 published journal articles and 3736 outcomes were identified . Overall , 50 % of efficacy and 65 % of harm outcomes per trial were incompletely reported . Statistically significant outcomes had a higher odds of being fully reported compared with nonsignificant outcomes for both efficacy ( pooled odds ratio , 2.4 ; 95 % confidence interval [ CI ] , 1.4 - 4.0 ) and harm ( pooled odds ratio , 4.7 ; 95 % CI , 1.8 - 12.0 ) data . In comparing published articles with protocol s , 62 % of trials had at least 1 primary outcome that was changed , introduced , or omitted . Eighty-six percent of survey responders ( 42/49 ) denied the existence of unreported outcomes despite clear evidence to the contrary . CONCLUSIONS The reporting of trial outcomes is not only frequently incomplete but also biased and inconsistent with protocol s. Published articles , as well as review s that incorporate them , may therefore be unreliable and overestimate the benefits of an intervention . To ensure transparency , planned trials should be registered and protocol s should be made publicly available prior to trial completion Recent investigations measuring platelet aggregation during 10 orthotopic liver transplantations showed a significant decrease in platelet aggregation immediately after reperfusion and in the perfusate . As prostagl and in E1 has been shown to exhibit a beneficial effect in the treatment of ischemic injury of the liver , we investigated in a prospect i ve , r and omized , and open study the effect of PGE1 infusion during OLT on platelet function .  Ten patients were r and omized to receive a continuous PGE1 infusion ( PG group ) and another ten patients served as controls .  Platelet function was determined ex vivo by measuring the adenosine diphosphate- , collagen- , and ristocetin-induced aggregation in platelet-rich plasma . A significantly higher platelet aggregability was measured in the PG group throughout the whole operation for ADP ( 1 and 2 mumol/L ) and collagen ( 0.5 micrograms/ml ) . The same was true for collagen ( 1 microgram/ml ) and ristocetin ( 1.2 mg/ml ) after reperfusion . Not only the postreperfusional decrease in platelet aggregation but also the decline in platelet count that occurred in the control group could be prevented greatly by PGE1 infusion . In the perfusate , released from the liver graft vein by flushing with arterial blood , a significantly lower platelet aggregability was seen in comparison with the systemic circulation before reperfusion in the control group , a difference that was not found when PGE1 infusion was given intraoperatively . However , blood product requirements during OLT were comparable in both groups . In conclusion , PGE1 therapy during OLT preserves platelet function and prevents the drop in platelet count observed in the control group after revascularization Summary Alprostadil ( prostagl and in Ei ) administration to liver transplant recipients has been shown to result in a significant reduction in the duration of hospital admission for transplantation , and in the need for re-operations ( other than re-transplants ) and renal support . To study the economic impact of this finding , we examined data from a controlled trial for all single-transplant surviving patients ( 42 alprostadil , 49 controls ) for whom complete billing records were available for transplant days -2 to + 150 . All costs were measured in 1992 US dollars . Patients given alprostadil had lower total charges [ mean ± st and ard deviation ( SD ) $ US175 297 ± $ US70 652 ] than patients given placebo ( mean ± SD $ US225 672 ± $ US187 208 ) [ p = 0.043 ] . The data suggest that the use of alprostadil may have a significant favourable impact on the cost of liver transplantation Methods for combining data from several studies exist and appear to be quite useful . None satisfactorily addresses the question of what studies should be combined . This issue is the most serious method ological limitation . Even studies with statistically significant interaction might still be combined if the effect were in the same direction . Thus , substantial scientific input is required as to what criteria must be met by each potential study . Much can be learned from combining or pooling data but it must be done cautiously . Pooling exercises do not replace well design ed prospect i ve clinical trials . Efforts for establishing basic design criteria to allow for multicentre and multicountry trials to be more easily combined might be useful . BACKGROUND / AIMS Living related donor  liver transplantation must hold on in absolute donor safety . Nevertheless , the risks to the donors are increased because of the use of right lobe for size mismatch . Therefore the intensive management for donor operation can hardly be overestimated . In this study , we investigated the utility of prostagl and in E1 , methylprednisolone and C-tube in the postoperative management for donor operation based on our underst and ing of the mechanisms of liver injury after massive hepatectomy . METHODOLOGY Outcome of the thirteen donors , whose right lobe was removed ( right lobe group : 7 cases ) or the left lobe only ( 3 cases ) and left lobe plus cau date lobe ( 3 cases ) ( left lobe group : 6 cases ) from 1999 March to 2000 August , for living related liver transplantation were evaluated . Indication for right lobe living related liver transplantation was basically defined as an estimated left lobe volume/recipient body weight ratio ( GVBW ratio ) of < 0.8 % ( range : 0.65 - 1.4 , right lobe group : 1.05 + /- 0.18 , left lobe group : 0.89 + /- 0.16 ) . RESULTS The donors recovered from the operation without the differentiation between right and left lobe group . There were no significant differences in the operative time , the operative hemorrhage , the hospital stays and the postoperative liver function in the two groups . They had no bile leakage and no serious complications . We experienced the left lobe donor who suffered from a cholangitis without any infection and he recovered by the administration of prostagl and in E1 and steroid . They improved bile secretion and bilirubinemia . Eleven recipients ( 84.6 % ) were successfully treated . The two causes of death were the sepsis ( right lobe ) and brain hemorrhage ( left lobe ) . CONCLUSIONS The current series of right lobe donation was able to show successful results as well as left lobe donation by the postoperative management with steroid , prostagl and in E1 and C-tube drainage based on our underst and ing of liver injury after massive hepatectomy in the adult-to-adult living donor liver transplantation BACKGROUND Acute renal failure is a frequent complication following orthotopic hepatic transplantation . A reduction in the synthesis of intrarenal vasodilator prostagl and ins has been proposed as having an important role in the pathogenesis of renal insufficiency associated with hepatic dysfunction , as well as in the nephrotoxicity associated with cyclosporine and FK506 immunosuppressive therapy . Therefore , administration of vasodilator prostagl and ins may improve renal function following hepatic transplantation . This study was design ed to determine the effect of continuous intravenous alprostadil ( prostagl and in E1 ) on postoperative renal function in hepatic transplant patients . STUDY DESIGN In a r and omized , double-blind , placebo-controlled trial , 21 patients who had undergone orthotopic hepatic transplantation and had a measured postoperative glomerular filtration rate ( GFR ) of less that 50 mL/minute received intravenous alprostadil at 0.6 microgram/kg/hour or placebo for five days . Glomerular filtration rate and effective renal plasma flow ( ERPF ) were measured by a single-injection clearance method using a radionuclide agent in 53 patients within 12 hours after admission to our surgical intensive care unit . Usual postoperative care was not modified . Radionuclide GFR and ERPF measurements were repeated on postoperative day 3 . Serum creatinine was measured preoperatively and postoperatively on day 3 and on day 5 . A 24-hour serum creatin 
    Output:
    
There was no significant increase in the risk of adverse events with prostagl and ins .
We found no evidence that the administration of prostagl and ins to liver transplanted patients reduces the risk of death , primary non-function of the allograft , or liver re-transplantation .