0000000000134021
AUTHOR
G. Otto
showing 8 related works from this author
Liver transplantation for hepatocellular carcinoma--is there a risk of recurrence caused by intraoperative blood salvage autotransfusion?
2011
<i>Background/Aims:</i> The use of intraoperative blood salvage autotransfusion (IBSA) during surgical approaches may contribute to tumour cell dissemination. Therefore, IBSA should be avoided in cases of malignancy. However, the risks of IBSA might be acceptable in liver transplantation (LT) for selected small hepatocellular carcinoma (HCC). <i>Methods:</i> In total, 136 recipients of LT with histologically proven HCC in the explanted liver were included in this analysis. With regard to tumour recurrence, 40 patients receiving IBSA despite HCC (IBSA group) were compared to 96 patients without IBSA (non-IBSA group). <i>Results:</i> Milan criteria as asses…
Transarterial Chemoembolization Before Liver Transplantation in 60 Patients With Hepatocellular Carcinoma
2007
Tumor recurrence is a major problem after orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC). In 60 patients OLT was performed for HCC after pretreatment by repeated transarterial chemoembolization (TACE). Forty-four recipients exceeded the Milan criteria. Recurrence-free 5-year survival was 65.2% and 5-year freedom from recurrence was 73.2%. During the waiting time, 14 patients experienced minimal change, which did not fulfill the definition of tumor progression according to official oncological criteria. Five-year freedom from recurrence among patients with stable compared with progressive disease was 93.3% versus 28.1%, respectively (P = .0001). A stri…
Remission of severe rheumatoid arthritis following liver transplantation.
1993
We present the case of a 32-year-old male who suffered from severe RA from the age of 21 years. After 9 years of active disease and poor response to therapy the patient developed severe hepatitis induced by the NSAID pirprofen. He went into fulminant hepatic failure necessitating emergency liver transplantation. Liver transplantation was followed by clinical and laboratory remission of his RA and he has remained virtually asymptomatic for more than 3.5 years. The possibility that this favourable clinical course was due to the immunosuppressive effect of the liver transplant rather than the ensuing immunosuppressive therapy is discussed.
Einfluß eines Shunts auf eine spätere Lebertransplantation
1998
Das Ziel eines portosystemischen Shunts vor Lebertransplantation ist die Behandlung der Osophagusvarizenblutung. Das Vorgehen ist mit potentiellen Risiken behaftet. Fur den TIPS bestehen diese in der relativ hohen Enzephalopathierate, der moglichen Leberdekompensation, des Shuntverschlusses und der Stent-Dislokation. Chirurgische Shunts bedingen einen erhohten Schwierigkeitsgrad bei Lebertransplantation und eine evtl. Pfortaderthrombose. Patienten, bei denen die Notwendigkeit der Transplantation dringlich erscheint, sollten als uberbruckende Masnahme einen TIPS erhalten. Bei Child-A-Patienten fuhren chirurgische Shunts zu sehr guten Langzeitergebnissen, so das diese Patienten moglichst nich…
Automatische Klassifikation der Lebersegmente nach Couinaud: Entwicklung eines neuen Algorithmus und Evaluierung an Spiral-CT-Datensätzen
2003
Purpose: To develop a software tool that analyzes the anatomy of the portal vein branches and assigns segmental and subsegmental branches according to Couinaud's classification system and to evaluate its accuracy. Materials and Methods: The algorithm was developed in C++ on a PC. The algorithm recognizes the three major branching patterns of the portal vein. Segmental and subsegmental branches are assigned to 8 segments following Couinaud and encoded by 8 colors. The software was evaluated using CT data sets of 39 patients. After the individual segmental anatomy of each patient was determined by an experienced radiologist, automatic classification was performed and the results were compared…
Treatment of Metachronous and Simultaneous Liver Metastases of Pancreatic Cancer
2009
<i>Aim:</i> Patients were analyzed who underwent treatment of liver metastases from pancreatic cancer. <i>Methods:</i> Selection criteria were the possibility of R0 resection of the primary and/or the liver metastases, no other sites of metastases, and the presentation of liver metastases. A comparison of treatment by surgery versus chemotherapy regarding overall survival and disease-free interval was performed. <i>Results:</i> Between 1996 and 2008, a total number of 23 patients were retrospectively identified from a prospective database of 193 cases of pancreatic cancer. In 14 cases, liver metastases were found simultaneously, and in 9 cases metachronou…
Flow and Pressure during Liver Preservation under ex situ and in situ Perfusion with University of Wisconsin Solution and Histidine-Tryptophan-Ketogl…
2006
Effective preservation of liver grafts is the first essential step for successful liver transplantation. Insufficient perfusion leads to ischemic-type biliary lesions after transplantation. Perfusion of the graft can be performed either in situ or ex situ, with gravity flow or pressure-controlled. Mainly University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK) solutions are used widespread in clinical liver transplantation. Due to a persistent lack of data, we performed this systematic investigation of in situ and ex situ perfusion of liver grafts with HTK (low-viscous) and UW (high-viscous) solutions at different pressure steps on the perfusion solution (gravity flow, 50, …
Ischemic type biliary lesions in histidine-tryptophan-ketoglutarate (HTK) preserved liver grafts.
2006
Ischemic type biliary lesions lead to considerable morbidity following orthotopic liver transplantation. The exact pathogenesis is unknown. One major hypothesis is that insufficient perfusion of the arterial vessels of the biliary tree, especially under perfusion with the high viscous University of Wisconsin solution, might be responsible for ischemic type biliary lesions. Due to low viscosity, HTK solution is reported to have a lower incidence of biliary complications. However, there is no data concerning ischemic type biliary lesions in HTK preserved livers. In this paper we report our results after orthotopic liver transplantation with special regard to ischemic type biliary lesions in …