Liver transplantation: perspectives after 250 liver transplants at the Ochsner Clinic

At the Ochsner Clinic we recently performed our 250th liver transplant. Reaching this milestone has led us to reflect back on the history of liver transplant, both at our own institution and nationally, noting the many achievements and improvements in liver transplantation during the relatively brief history of this therapeutic modality. Furthermore, there are a number of issues both medical and political which will likely be affecting how liver transplantation is performed in the future.

Mutagens in larger fungi. I. Forty-eight species screened for mutagenic activity in the Salmonella/microsome assay

Specimens of large fungi (mushrooms) were screened for mutagenic activity by the Salmonella/microsome assay, with strains TA98, TA2637 and TA100. Our of 48 species tested, 37 exhibited a significant but for the most part weak activity. The activity observed in the presence of S9 mix was typically between 0 and 50% of that without, and in no case was the activity increased in the presence of microsomal enzymes. Six metabolites reported to occur in some of the species included in this investigation were also tested. Significant mutagenic activity was found with isovelleral (5) from Lactarius sp., agaritine (3) from Agaricus bisporus and related sp. and beta-nitraminoalanine (7) from Agaricus silvaticus. Isovelleral may be a major mutagen in some of the sharp-tasting and mutagenic Russulaceae sp. A. bisporus (cultivated specimen) was weakly mutagenic toward all three strains of S. typhimurium, used, and agaritine was weakly active toward TA2637 alone. This implies that this fungus might contain other mutagenic material as well. beta-Nitraminoalanine was not found in the particular collection of A. silvaticus tested here. The mutagenicity observed for the fungus in this work may therefore be due to other metabolites. Even though many species found to be mutagenic are used as food, it seems premature to make specific recommendations about eventual health risks. Further information is needed about the chemistry and toxicology of the active compounds as well as about the effects of various methods used in preparing mushrooms for food.

Mutagens in larger fungi. II. The mutagenicity of commercial pickled Lactarius necator in the Salmonella assay

In the course of an ongoing screening of larger mushrooms for the occurrence of chemical mutagens, 33 out of 48 species tested exhibited a significant direct mutagenic activity in the Salmonella/microsome assay (Sterner et al., 1982). (No mutagens requiring metabolic activation were indicated.) These findings are of some concern, since mushrooms are used extensively as food in many areas, and there are strong indications that carcinogens in food are of considerable importance in cancer aetiology (Sugimura, 1979). A recent communication by Knuutinen and von Wright (1982) on the mutagenicity of 4 Lactarius species collected in Finland prompts us to report our own results from mutagenicity tests with commercially preserved (pickled) Lactarius necator.