Giovanni Boccaccio's (1313-1375) disease and demise: The final untold tale of liver and heart failure.

Giovanni Boccaccio's fatal disease(s) and cause of death have long remained a mystery. Now, for the first time, a thorough multidisciplinary reassessment has finally been carried out. By combining philological and clinical approaches, it is at last possible to suggest a solid retrospective diagnosis based upon a study of his correspondence, poetry and iconography, as well as references to his physical decay in coeval and later sources. It would appear that he suffered over the last three years of his life from hepatic and cardiac failure, conditions that resulted in edema and potentially even hepatic carcinoma. Focusing on an unusually well-documented case from the Middle Ages, this analysis of exceptionally high informative value reconstructs the symptoms of his medical conditions and finally permits us to clarify and explain the historical feaures, presentations and evolutionary history of the case at hand.

The elusive goal of liver support--quest for the Holy Grail.

The history of liver support devices is traced from early attempts with dialysis based on the known dialysability of ammonia--the major identified toxin in liver failure--and exchange transfusion with removal of protein-bound toxins, to the later techniques based on whole organ perfusion in extracorporeal circuits. Perfusion through charcoal as an adsorbent represented a major advance and remains a component of more recently introduced devices based on bioreactors of cultured hepatocytes and in the albumin dialysis techniques of molecular adsorbent recirculating system and the Prometheus device. The latter are the most highly efficient to date in toxin removal but whether survival is improved and the need for liver transplantation remain to be proven.

The first 50 liver transplants in New Jersey.

New Jersey's first liver transplant was performed on February 14, 1989, at UMDNJ-New Jersey Medical School. By May 1992, 50 patients, ranging in age from 16 to 65 years, had been transplanted. Liver transplantation is an accepted method of treatment for end-stage liver disease.