 E.1. Design: This study will be a prospectively performed, multi-center, double blinded, study drug versus placebo controlled study. It will test the hypothesis that post-operative administration of probiotics in HD patients will lead to a reduction in the occurrence of HAEC E.2. Study medication: VSL3 VSL Pharmaceuticals, Inc., Ft. Lauderdale, FL was provided in packets, each of which contained 900 billion viable lyophilized bacteria of 4 strains of Lactobacillus L. casei, L. plantarum, L. acidophilus, and L. delbrueckii subsp. bulgaricus, 3 strains of Bifidobacterium B. longum, L. breve, and B. infantis, and 1 strain of Streptococcus salivarius subsp. thermophilus designated hereafter as S. thermophilus. Maize starch was included as filler. Placebo was provided in identical bags containing 3 g of maize starch. VSL3 and placebo were administered once each night. The taste and smell of the active drugs were not readily identifiable. 