Abstract：
UNLABELLED:The aim of this study was to analyse the causes of death after liver transplantation in order to find and to avoid preventable fatal complications if possible. METHODS:Between September 1988 and September 1993 415 orthotopic liver transplantations in 382 patients were performed at the Rudolf Virchow University Hospital in Berlin. During the same interval 41 (10.7%) of these patients died. Their clinical records were reviewed. RESULTS:The main cause of death was infection (29.3%), followed by recurrent malignancy (21.9%). Less patients died because of hepatitis B-reinfection (14.6%), chronic rejection (7.3%), hemorrhage (7.3%), cardiac failure (7.3%), trauma (4.8%), hypoxia (4.8%) and recurrence of alcoholic liver disease (4.8%). There was a wide spectrum of opportunistic infectious agents with CMV and Pneumocystis carinii being the most important pathogenic organisms. Only one isolated bacterial infection as principle cause of death was found. In all fatal infections the lung was the primary site of infection, 7 patients additionally developed sepsis. Altogether 75 patients (19.6%) with hepatitis B-cirrhosis were transplanted. Six of them (8%) developed a fatal hepatitis B-reinfection. Malignancy was the indication for OLT in 41 patients (10.7%). Six of these patients (14.6%) died because of recurrent tumor. Regarding the whole series, most deaths occurred four to twelve months (58.5%) and only five (12.2%) during the first month after OLT. CONCLUSION:Recurrence of primary disease is an important factor regarding total mortality. Therefore it is necessary to practise a careful selection of liver transplant recipients. In the future more attention needs to be drawn towards prevention, identification and management of opportunistic infections.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Rayes N,Bechstein WO,Keck H,Blumhardt G,Lohmann R,Neuhaus Psubject
Has Abstractpub_date
1995-01-01 00:00:00pages
435-8issue
6eissn
0044-409Xissn
1438-9592journal_volume
120pub_type
杂志文章abstract：:The analysis of the genetic causes of tumor development led to the identification of many genes affected in these diseases, which play a role in the control of cell proliferation and apoptosis. However, these studies also suggested that not all alterations are equal with regard to their effect on tumor growth, and the...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：2000-01-01 00:00:00
abstract：:Ureterosigmoidostomy was the method of choice for continent urinary diversion in cases of bladder exstrophy. The development of colonic cancer at the ureterocolic junction is one of the major complications in the late course of this procedure. The risk of large bowel carcinoma is increased 150-500-fold compared to the...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：:In a 19 year old man with a single kidney the development of a large Douglas' abscess was followed by anuria; The various causes are discussed. It is resonable to assume, that the obstruction resulted from longitudinal tension of the ureter over the iliace vessels (iliac sign). ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1976-01-01 00:00:00
abstract：:Stabilisation of pelvic ring fractures by means of external fixation has been found to provide certain advantages over internal fixation. Good results can be achieved, provided that optimum forms and techniques of assembly are used. The authors' indications are reported together with their assembly techniques and form...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1987-01-01 00:00:00
abstract：:Thoracotomy and lung-resection are often followed by a decrease of the oxygenation of blood and disturbances of the acid-base-balance. Both ventilation and circulation must be restored to normal and therefore adequate levels of cardiac output, peripheral resistance, electrolytes and kidney-function are required. ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1977-01-01 00:00:00
abstract：:Fractures of the femoral shaft are combined in 2-5% of all cases with an ipsilateral fracture of the proximal femur. These double fractures are mostly caused by high energy trauma. An analysis of 9 selected papers points to the problem. In more than 10% the proximal fracture is not diagnosed initially. In the literatu...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1995-01-01 00:00:00
abstract：:Liver cuts were performed on 21 Mini-Leewe-pigs and than closed with suture and by ultrasonic welding with Ligament-FIMOMED and Gelaspon. The sound pressure leads to the forced penetration of the monomere into performed gaps. The application of the ultrasound is sensible in order to force the polymerisation. The exper...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1990-01-01 00:00:00
abstract：:Accidental ingestion of foreign bodies is a common problem in infants and childhood, but ingestion of magnetic construction toys is very rare. In the case of ingestion of multiple parts of these magnetic construction toys, they may attract each other through the intestinal walls, causing pressure necrosis, perforation...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-0028-1098941
更新日期：2010-06-01 00:00:00
abstract：:Most patients with Crohn's disease have to be operated on. Necessity to loose some amount of the intestine and time-point of the surgical intervention may be derived from the irreversible cascade of the inflammatory process and the limitations of the conservative treatment. In ileocecal disease indications for surgery...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1998-01-01 00:00:00
abstract：:We report a retrospective analysis of 61 patients admitted during the years 1974 to 1992 after having recently swallowed a corrosive agent. Within 24 hours, the localisation, severity and extent of the injury had been determined by endoscopy. In 13 patients the injury was restricted to the oropharynx, and in 48 it inv...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1995-01-01 00:00:00
abstract：:The ileo-anal pouch procedure: Complications, quality of life, and long-term results. Restorative proctocolectomy with construction of an ileal pouch-anal anastomosis (IPAA) has evolved as the surgical therapy of choice for patients with ulcerative colitis (UC) and patients with familial adenomatous polyposis (FAP). 6...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2001-19197
更新日期：2001-01-01 00:00:00
abstract：INTRODUCTION:Over the last decade endovascular stenting of aortic aneurysm (EVAR) has been developed from single centre experiences to a standard procedure. With increasing clinical expertise and medical technology advances treatment of even complex aneurysms are feasible by endovascular methods. One integral part for ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-0035-1546261
更新日期：2015-10-01 00:00:00
abstract：:The importance of carcinoembryonic antigen as a tumor marker to the follow-up of patients with liver metastases from colorectal cancer was investigated. It was reported about 29 patients receiving chemotherapy. We estimated the effect of therapy according to sonographic and computer tomographic criteria and related to...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：INTRODUCTION:The mean prevalence of thyroid nodules in adults is about 20% and increases with age. Most of the thyroid nodules are benign, and are rarely malignant. However, malignancy can often only be conclusively determined after resection. Therefore, it is essential that the surgical technique should be free of com...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/a-1024-4662
更新日期：2019-12-01 00:00:00
abstract：:Femorodistal bypass using exclusively PTFE is known to have a poor prognosis, mostly because of the development of myointimal hyperplasia (MIH). Several vein patch techniques are established but the role of hemodynamics within the anastomotic site has only been explained insufficiently and is hardly considered clinica...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2001-12419
更新日期：2001-02-01 00:00:00
abstract：:For the first time the surgical technique of right and left adrenalectomy by a posterior percutaneous retroperitoneoscopic access is described. The adrenal gland is mobilized after creation of a pneumoretroperitoneum and insertion of 3-4 trocars beneath the 12th rip. Indications for this new method are small, benign a...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1995-01-01 00:00:00
abstract：UNLABELLED:Peritoneal tumor dissemination has been considered as an incurable condition with fatal outcome. However cytoreductive surgery followed immediately by hyperthermic chemoperfusion has been described both for the treatment and prevention of locoregional cancer spread from various origins. This paper summarizes...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2004-818764
更新日期：2004-04-01 00:00:00
abstract：:Intractable pain is an important indication for stereotactic operations in deep structures of the brain. The targets are situated in primary and secondary sensomotoric regions of the thalamus, dependent or independent on cortical areas. In clinical practice it is necessary to combine two or three targets in the thalam...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：INTRODUCTION:The aim of the study was to evaluate the efficiency of the endovenous use of laser for treatment of varicose veins. In particular the influence of laser energy on the perivenous temperature, the postoperative clinical and duplex ultrasound course was taken into account. METHOD:The patients were divided in...
journal_title：Zentralblatt fur Chirurgie
pub_type： 临床试验,杂志文章
doi：10.1055/s-2006-921389
更新日期：2006-02-01 00:00:00
abstract：:Background The relevance of ultrasound (US) in diagnosing acute appendicitis is controversial. The validity of US in comparison with other imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), is unclear, as is the difference between surgeon-performed ultrasound (SPUS) and radiolog...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-0043-114414
更新日期：2017-08-01 00:00:00
abstract：:The pancreas has been excluded from laparoscopic surgery ever since. The technical possibilities of laparoscopic left resection of the pancreas in pigs are examined in this study. Mobilization of the left pancreatic segment up to the confluence area (splenic vein and upper mesenteric vein) was possible preserving the ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1995-01-01 00:00:00
abstract：INTRODUCTION:An adequate approach to surgically induced sepsis needs an early and targeted antibiotic therapy in addition to focus sanitation. The PCR-based LightCycler Septifast test can detect 90 % of the sepsis-associated microoganisms (e. g., Gram-positive, Gram-negative bacteria, fungi) within only a few hours. P...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-0028-1098776
更新日期：2009-06-01 00:00:00
abstract：:The change of surgical operations from inpatient to outpatient conditions as a method of lowering costs in health care has lead to a significant rise in the number of outpatient operations, especially in varicose vein surgery. Hospitalisation is still required in special cases. The criteria of 146 patients with varico...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2001-16278
更新日期：2001-07-01 00:00:00
abstract：:Therapeutic bronchoscopy is widely used in the treatment of airway stenosis, fistula, and pulmonary bleeding. Recanalisation of tracheobronchial stenoses can be treated by Nd: YAG-laser or stent implantation. While the use of laser irradiation is limited to intraluminal obstruction, stenting is also effective in steno...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1998-01-01 00:00:00
abstract：:To avoid or reduce postoperative ileus, the operative trauma should be minimized and epidural anesthesia for spinal inhibition of the sympathetic nervous system or i. v. lidocaine should be used, all of which probably act by reducing visceral afferent nerve fiber activity. Recent data suggest that perioperative fluid ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-2003-38797
更新日期：2003-04-01 00:00:00
abstract：:A surgical association between skeletal muscle and heart muscle dates back to experiments at the beginning of this century. Initially, the use of skeletal muscles aimed at plastic reconstructions of myocardial defects and enhancement of myocardial blood flow. The application of the contractile force of the skeletal mu...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1996-01-01 00:00:00
abstract：:The authors report on their experience concerning myocardial protection during open heart surgery making use of hypothermic cardioplegia. From September 1977 to April 1980 they operated on 637 patients applying this method. 155 cases were evaluated. Hypothermic cardioplegia extends the tolerance of the myocardium to i...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:38 patients who had undergone surgical repair of injured ligaments of the knee joint were reexamined. Best results were obtained in cases of osseous avulsions. Early suture of lacerated ligaments in combination with primary plasty of the ligament showed good results. The author emphasizes the active cooperation of the...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:There are various ways and means of performing the callus distraction procedures used more and more frequently in the clinic today. The interplay of numerous factors affects the macroscopical and microscopical morphological appearance and thus the quality of the bone regenerate. The radiological appearance during and ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1994-01-01 00:00:00
abstract：:Surgical therapy of incidentally postoperative diagnosed small sporadic medullary thyroid cancer (MTC) is discussed controversially. In principle completion thyroidectomy with neck dissection and regulary tumor follow-up are under discussion. A total of 277 patients with MTC were treated between 1986 and 2004. In 22 c...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2005-836891
更新日期：2005-10-01 00:00:00
