Based on our ability to manipulate Ad5 capsid proteins as well as internal gene loci, we will be able to establish novel vectors that allow for the production of multivalent vectors that may act as a vaccine 'cocktail'. These vectors with capsid-incorporated antigens will have the potential to vaccinate patients against HIV by producing a robust anti-HIV humoral and T cell response. Our data illustrates that there is a diverse immunological response/ profile of vaccination with capsid-modified vectors compared to that of vector containing wild type hexon. This fact provides the rationale that a heterologous prime boost strategy with our hexonmodified vector followed by the wild type hexon vector could potentially achieve an even greater anti-HIV immune response. In addition, these vectors may have great potential to circumvent the drawbacks seen in the general population related to Ad5 PEI. Our future plans include transitioning these vectors to a 'gutless' [53] [54] [55] [56] [57] system in order to determine the duration and quality of HIV antibody production. In combination with the 'gutless system' we plan to decrease Ad5 PEI through the use of chemical conjugates such as Polyethylene Glycol [58, 59] and/or Ad vector chimeras. Model of end stage liver disease (MELD) score greater than 23 predicts length of stay in the ICU but not mortality in liver transplant recipients INTRODUCTION: The impact of model of end stage liver disease (MELD) score on postoperative morbidity and mortality is still elusive, especially for high MELD. There are reports of poorer patient outcome in transplant candidates with high MELD score, others though report no influence of MELD score on outcome and survival. METHODS: We retrospectively analyzed data of 144 consecutive liver transplant recipients over a 72-month period in our transplant unit, from January 2003 until December 2008 and performed uni- and multivariate analysis for morbidity and mortality, in particular to define the influence of MELD to these parameters. RESULTS: This study identified MELD score greater than 23 as an independent risk factor of morbidity represented by intensive care unit (ICU) stay longer than 10 days (odds ratio 7.0) but in contrast had no negative impact on mortality. Furthermore, we identified transfusion of more than 7 units of red blood cells as independent risk factor for mortality (hazard ratio 7.6) and for prolonged ICU stay (odds ratio [OR] 7.8) together with transfusion of more than 10 units of fresh frozen plasma (OR 11.6). Postoperative renal failure is a strong predictor of morbidity (OR 7.9) and postoperative renal replacement therapy was highly associated with increased mortality (hazard ratio 6.8), as was hepato renal syndrome prior to transplantation (hazard ratio 13.2). CONCLUSIONS: This study identified MELD score greater than 23 as an independent risk factor of morbidity represented by ICU stay longer than 10 days but in contrast had no negative impact on mortality. This finding supports the transplantation of patients with high MELD score but only with knowledge of increased morbidity. Liver transplantation is still a complex and cost-intensive procedure [1] and the results are influenced by many interrelated factors. As liver transplantation has become a universally accepted treatment for end-stage liver disease, the number of patients accumulating on the waiting list has gradually outweighed the scarce resources of available organs. Fair allocation of donor livers to patients with end-stage liver disease is a difficult task. The USA and Europe used prioritization systems based on waiting time and on the parameters of the Child-Turcotte-Pugh score [2] . Since February 2002, the United Network for Organ Sharing introduced a new allocation policy for cadaveric liver transplants, based on the model for endstage liver disease (MELD) score [3] . This new policy stratifies the patients based on their risk of death while on the waiting list [4] . The impact of MELD score on postoperative mortality remains elusive. There are reports of reduced survival in groups with high MELD scores [5, 6] , but also reports of no influence of MELD score on survival [7, 8] .