Revised treatment recommendations for patients with BCS and/or PNH. As soon as it is established that BCS is secondary to PNH, eculizumab should be considered in the treatment paradigm for these at-risk patients (shaded box indicates proposed revision to the original Hoekstra algorithm). Adapted from Hoekstra J, et al. J Hepatol, 2009, with permission from Elsevier . OLT, orthotropic liver transplant.