Liver transplantation has been successfully used in the treatment of a large number of liver diseases. The largest patient group comprises patients with end stage decompensated liver disease. Decompensation is defined as the presence of cirrhosis and one or more of the following: jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome or bleeding oesophageal varices. In general patients in this category should be considered for liver transplantation, if available. Guidelines for liver transplant assessment have been published by both the British Society of Gastroenterology and the American Association for the Study of Liver Disease. These guidelines provide a good basis for patient selection. As new information becomes available the indications for individual diseases may change somewhat. One of the most important changes in recent years was the introduction of the MELD/PELD scoring system. This is the model for end stage liver disease which provides a reasonably robust estimate of prognosis for individual patients. Prior to this patient waiting time on the transplant list was one of the principal determinants of priority for liver allocation. The MELD scoring system has been widely adopted with the aim of allocating the available livers to patients in the greatest clinical need.
The present study was conducted to investigate the effects of Trichoderma harzianum and Bacillus thuringiensis alone or with gradual levels of NPK on photosynthesis, growth, fruit quality, aroma improvement and reduced radionuclides of key lime fruits. The lemon seedlings were treated with (T0) without fertilizers as control, (T1) 100g of NPK at 100%, (T2) 5 g of Trichoderma. harzianum at 50% + 50 g of NPK at 50%, (T3) 5 g of Bacillus thuringiensis at 50% + 50 g of NPK at 50 %, (T4) 7.5 g of Trichoderma harzianum at 75% + 25 g of NPK at 25 %, (T5) 7.5 g of Bacillus thuringiensis at 75% + 25 g of NPK at 25 %, (T6) 10 g of Trichoderma harzianum at 100 % and (T7)10 g of Bacillus thuringiensis at 100 %. The results showed that T2 increased net photosynthetic rate, stomatal conductance, transpiration rate, internal CO2 concentration, fresh and dry root biomass by 209%, 74%, 56%, 376%, 69.4% and 71.6%, while, T5 increased root volume, root length, and root tip number by 27.1%, 167%, and 67%, respectively over the control trees. The microbial treatments developed cortex, vascular cylinder and tracheal elements of the root. Fruit number, length, diameter, weight, pulp thickness, pulp/peel ratio, juice, total soluble solids (TSS), pigment contents and antioxidant activity increased significantly in the T2 treatment. Vitamin C, total phenols, total flavonoids, and total sugar content increased by 1.59-, 1.66-, 1.44- and 2.07- fold in T5 treated fruits compared to the control. The two microbes increased volatile compounds and decreased radionucleotides in the fruit, moreover, 27 identified and 2 (two) unmatched volatile compounds were identified by GCMS analysis. It is concluded that T. harzianum and B. thuringiensis with 25-50 g NPK treatments improved photosynthesis, root structure, fruit growth, fruit quality, aroma and lessened radionuclides in key lime fruits.