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  • Key words Liver transplantation  (2)
  • 2000-2004
  • 1995-1999  (2)
  • 1980-1984
  • 1997  (2)
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  • 2000-2004
  • 1995-1999  (2)
  • 1980-1984
Year
  • 1997  (2)
  • 1
    ISSN: 1432-2277
    Keywords: Key words Liver transplantation ; interleukin-8 ; Liver preservation ; interleukin-8 ; Interleukin-8 ; liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serum levels of interleukin-8 (IL-8) were investigated in the perioperative phase of liver transplantation (LTx) in order to help determine whether this cytokine might serve as a parameter for preservation injury. In a study of 45 patients undergoing LTx, systemic IL-8 was estimated at the end of the anhepatic phase, at 30, 60, and 120 min after reperfusion of the graft, and 24 h and 7 days after LTx. A maximum mean concentration of 665 ± 135 pg/ml was seen 60 min after LTx. The minimum was found on the 1st postoperative day (POD 1): 328 ± 33 pg/ml. Significant changes were found between 60 min and PODs 1 and 7, as well as between 120 min and POD 1. Differences in cold ischemia time were not found to be significant. We conclude that monitoring of systemic IL-8 levels is not useful in the development of new liver preservation concepts.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Lebertransplantation ; Postoperative Komplikationen ; Interventionelle Radiologie ; Angioplastie ; Stents ; Drainage ; Key words Liver transplantation ; Vascular and biliary complications ; Angioplasty ; Stents ; Drainage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: Postoperative complications contribute significantly to the morbidity and mortality of liver transplant patients. The management of these complications requires a multidisciplinary approach in which interventional radiology plays an integral role. Indications, techniques, and results of radiological interventions in the management of the liver transplant patient are presented. Material and methods: During a 10-year period, 52 out of 420 liver transplant recipients underwent radiological interventions, including angioplasty (n = 20), embolization (n = 2), percutaneous drainage (n = 11), and biliary interventions (n = 19). Results: Nine out of ten arterial stenoses located at the anastomoses (n = 8), within the liver (n = 1) and in the coeliac trunk (n = 1) were successfully treated by balloon dilatation. Angioplasty of supra- or infrahepatic anastomotic stenoses of the IVC (n = 5) provided long-term success only in combination with stent implantation. Portal vein stenoses and chronic thrombosis were treated by balloon dilatation and stent insertion via transhepatic catheterization of the portal vein. Late strictures of bile-duct anastomoses can be managed by ante- or retrograde interventions. If biliary complications are related to inflammatory or septic problems, the prognosis of graft survival is poor. Conclusion: Interventional radiological procedures are very useful in the management of vascular and biliary complications after liver transplantation. These techniques provide a cure in many situations, and thus, surgical interventions may be avoided in selected cases.
    Notes: Zusammenfassung Die komplexe chirurgisch-technische Operation sowie immunologische und ischämieverursachte Probleme tragen zur relativ hohen Komplikationsrate nach Lebertransplantation bei, die grundsätzlich organ- bzw. lebensbedrohlich für den Patienten sind. Interventionelle radiologische Techniken sind aufgrund ihres minimal-invasiven Charakters in der klinischen Versorgung dieser Komplikationen akzeptiert. Über 10 % der lebertransplantierten Patienten im Klinikum Großhadern sind im Verlauf mit vaskulären (n = 22) oder biliären (n = 19) postoperativen Komplikationen einer interventionellen radiologischen Behandlung zugeführt worden. Wichtigste Verfahren sind die Angioplastie (n = 20), die Katheterembolisation (n = 2), die perkutanen Drainageverfahren (n = 11) und Gallengangsinterventionen (n = 19). 20 von 22 vaskulären Interventionen wurden technisch erfolgreich durchgeführt. Für die Langzeitprognose des Organs bzw. der Patienten ist die aktuelle Organfunktion zum Zeitpunkt der Intervention entscheidend; dies entspricht weitgehend den Ergebnissen nach operativen Revisionen. Bei biliär-septischen Komplikationen ist die Organprognose als deutlich eingeschränkt anzusehen. Interventionelle Eingriffe bei Problemen der biliären Anastomosen sind als erster Therapieschritt akzeptiert und können auch in der Langzeitbeobachtung eine zufriedenstellende Problemlösung durch Ballondilatation und Prothesenimplantation gewährleisten. Interventionelle radiologische Techniken spielen in differentialtherapeutischen Überlegungen zur Behandlung postoperativer Komplikationen eine wichtige Rolle. Bei entsprechender Patientenselektion sind sie als erster Therapieschritt einzusetzen.
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