Abstract:
BACKGROUND:With regard to quality of life and organ shortage, follow-up after liver transplantation (LT) should consider risk factors for allograft failure in order to avoid the need for re-LT and to improve the long-term outcome of recipients. Therefore, the aim of this study was to explore potential risk factors for allograft failure after LT. MATERIAL AND METHODS:A total of 489 consecutive LT recipients who received follow-up care at the University Hospital of Muenster were included in this study. Database research was performed, and patient data were retrospectively reviewed. Risk factors related to donor and recipient characteristics potentially leading to allograft failure were statistically investigated using binary logistic regression analysis. Graft failure was determined as graft cirrhosis, need for re-LT because of graft dysfunction, and/or allograft-associated death. RESULTS:The mean age of recipients at the time of LT was 50.3 ± 12.4 years, and 64.0 % were male. The mean age of donors was 48.7 ± 15.5 years. Multivariable statistical analysis revealed male recipient gender (p = 0.04), hepatitis C virus infection (HCV) (p = 0.014), hepatocellular carcinoma (HCC) (p = 0.03), biliary complications after LT (p < 0.001), pretransplant diabetes mellitus (p = 0.03), and/or marked fibrosis in the initial protocol biopsy during follow-up (p = 0.001) to be recipient-related significant and independent risk factors for allograft failure following LT. CONCLUSION:Male recipients, patients who received LT for HCV or HCC, those with pretransplant diabetes mellitus, and LT recipients with biliary complications are at high risk for allograft failure and thus should be monitored closely. HINTERGRUND:Im Hinblick auf die Lebensqualität und den herrschenden Organmangel sollte die Nachsorge nach einer Lebertransplantation (LT) Risikofaktoren für eine Transplantatdysfunktion berücksichtigen, um sowohl die Langzeitergebnisse zu verbessern als auch Retransplantationen zu vermeiden. Ziel dieser Studie war es daher Risikofaktoren für ein Organversagen nach einer LT zu evaluieren. METHODEN:489 lebertransplantierte Patienten wurden konsekutiv in diese retrospektive Studie eingeschlossen. Es wurde eine Datenbankrecherche durchgeführt. Mittels einer binären Regressionsanalyse wurden potentielle Risikofaktoren eines Transplantatversagens nach einer LT ermittelt. Als Transplantatversagen wurden eine Transplantatzirrhose, die Notwendigkeit einer Re-LT und der transplantatassoziierte Tod definiert. ERGEBNISSE:Das mittlere LT-Empfängeralter lag bei 50,3 ± 12,4 Jahren. 64 % der Empfänger waren männlich. Das Spenderalter lag bei 48,7 ± 15,5 Jahren. Die statistische Analyse ergab folgende unabhängige Risikofaktoren für ein Transplantatversagen: männliches Empfängergeschlecht (p = 0,04), Hepatitis-C-Virus-Infektion (HCV) (p = 0,014) und hepatozelluläres Karzinom (HCC) (p = 0,03) als Grunderkrankung, Prätransplantationsdiabetes (p = 0,03) sowie biliäre Komplikationen (p < 0,001) und/oder deutliche Fibrose in der Protokoll-Biopsie während der Nachsorgezeit (p = 0,001). SCHLUSSFOLGERUNG:Männliche Empfänger, Patienten mit HCV bzw. HCC als Grunderkrankungen, solche mit Prätransplantationsdiabetes sowie LT-Empfänger mit biliären Komplikationen haben ein erhöhtes Risiko für ein Transplantatversagen und sollten daher speziell hinsichtlich dieser Risikofaktoren nachgesorgt werden.
journal_name
Z Gastroenteroljournal_title
Zeitschrift fur Gastroenterologieauthors
Huesing-Kabar A,Dohna CZ,Heinzow H,Cicinnati VR,Beckebaum S,Schmidt M,Gerth HU,Pohlen M,Wilms C,Palmes D,Schmidt HH,Kabar Idoi
10.1055/s-0043-125225subject
Has Abstractpub_date
2018-07-01 00:00:00pages
745-751issue
7eissn
0044-2771issn
1439-7803journal_volume
56pub_type
杂志文章abstract::The effects of surgical and chemical sympathectomy on various gastric functions was studied in rats. From the results it is concluded that the sympatho-adrenal system inhibits gastric acid secretion and mucosal blood flow. The regulation of pepsin secretion by the sympathetic nervous system appears controversial: unde...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1987-04-01 00:00:00
abstract::In a nine-year period, 46 patients with early gastric cancer were diagnosed and operated at a county hospital. Fiberscopy of the stomach raised the percentage of early gastric cancer from 1% in a five year pre-endoscopic period to 11.9% with endoscopy. On an average, subjects with early gastric cancer were 8 years you...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
abstract::Budesonide is a locally acting steroid with a high first-pass metabolism in the liver and low systemic effects. We performed the first pilot study comparing budesonide foam (1 mg/50 ml b.i.d.) with mesalazine enemas (4 g/60 ml o.d.). 33 patients from 3 centres were enrolled in this open randomized clinical trial. 16 p...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1055/s-2000-14869
更新日期:2000-04-01 00:00:00
abstract::The retention of 75Se-homotaurocholic acid (75SeHCAT) was measured in 12 healthy controls and in 21 patients with Crohn's disease and compared with the maximum postprandial rise in the serum concentration of cholylglycine (CG) in order to detect bile acid malabsorption. The retention of 75SeHCAT was lowered in all pat...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00
abstract::We report on a 19-year-old male patient with chronic HBeAg-positive hepatitis B-infection and agranulocytosis as a severe side effect of pegylated interferon alpha therapy. Within the first six months of therapy the hepatitis B virus DNA became undetectable in parallel with a significant decrease of the HBsAg serum co...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0029-1245768
更新日期:2011-05-01 00:00:00
abstract::Fibrolamellar hepatocellular carcinoma of the liver is a rare variant of hepatocellular carcinoma with characteristic morphological patterns and a good prognosis. Preoperatively the tumor is rarely diagnosed. Surgical treatment is resection, hemihepatectomy or transplantation of the liver. We report a case of a 51 yea...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract::We investigated the effect of a known T cell mitogen, phytohemagglutinin (PHA) and the neuropeptide beta-endorphin on the in vitro lymphocyte proliferative response in patients with ulcerative colitis and in health persons. We found that patients with ulcerative colitis show enhanced reactivity to PHA, when incubated ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:Renal cell carcinomas are the most common primary tumors leading to pancreatic metastases. The differentiation of metastases from primary pancreatic tumors is important for the prognosis. Echo-enhanced power-Doppler sonography may be used for the differential diagnosis of tumors. In this study, the contrast ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-2001-16690
更新日期:2001-08-01 00:00:00
abstract::Perianal and perineal ultrasound is an effective but rarely applied diagnostic modality. Transmural inflammation, fistula and abscesses in patients with inflammatory bowel disease can be delineated and perirectal tumours can be staged. The method is complementary to endorectal ultrasound. Also oblique transsphincteric...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1027518
更新日期:2008-06-01 00:00:00
abstract::We report a rare case of a 52 year old patient with multiple gastric wall abscesses. In 1987 a selective proximal vagotomy was performed. Because of non-specific gastric symptoms in 1993 an endoscopy and an endoscopic ultrasound was performed at another hospital which resulted in the likely diagnosis of multiple leiom...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Helicobacter pylori is a human pathogen that causes chronic gastritis and peptic ulcers. Epidemiological studies demonstrated that individuals who are blood group 0 positive or represent non-secretors of their blood group antigens are more likely to develop peptic ulcers. The Lewis(b) blood group antigen has...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-2002-30115
更新日期:2002-05-01 00:00:00
abstract::Gallstone disease is more common in the elderly. In this short review, we summarize guideline-based recommendations for the diagnosis and treatment of biliary diseases in elderly patients. Warning episodes of biliary colic represent a general indication for cholecystectomy to avoid stone-related complications. Elderly...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1366158
更新日期:2014-05-01 00:00:00
abstract::The present paper, based on the current literature, considers the practical aspects of bile acid radioimmunoassays. The problems associated with the raising of specific antisera and their characterization are discussed. Features of assay design for bile acids are considered. Solid-phase radioimmunoassays are described...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1978-03-01 00:00:00
abstract::In 9 cases of choledocholithiasis and 2 cases of endoscopically determined stenosis of the papilla in which an EPT could not be successfully performed it was possible to carry out a prepapillary choledochoduodenal fistula by means of endoscopy. Subsequently the fistula was split in the cranial direction using a papill...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1985-08-01 00:00:00
abstract::This guideline provides evidence-based key recommendations for diagnosis and therapy of gallstones and upgrades version 2000. It was developed by an interdisciplinary team of gastroenterologists, surgeons, radiologists, geneticists, external comparative quality assurance and patient support groups under the auspices o...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,实务指引
doi:10.1055/s-2007-963437
更新日期:2007-09-01 00:00:00
abstract::The phenomenon of the spontaneous parietal cell sensitivity not induced by drugs is described in a number of gastric diseases. Different parietal cell sensitivity can be assumed. 1. when there is a shift in the dose response curve between the aid output and continuous intravenous application of a stimulant, 2. when th...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1981-07-01 00:00:00
abstract::The role of endogenous gastrin in the pathogenesis of "idiopathic" ulcer disease is difficult to determine; however, gastrin is probably only of limited importance besides various probable more important factors. In conditions associated with uncontrolled gastrin production by a gastrin secreting tumor or in cases in ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract::In 26 patients endoscopic-radiologic pancreography routinely performed caused severe pain with certain origin from pancreatic glan. Pain could be stopped immediately and with constant effect by lingual application of nitroglycerine. According to these informations we suppose that pancreatic pain is started by vascular...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1976-11-01 00:00:00
abstract::We report on the case of a 55-year-old patient suffering from progressive systemic sclerosis (PSS). The patient was sent to our department when clinical symptoms of an acute upper gastrointestinal hemorrhage occurred. Upper endoscopy showed a watermelon stomach and fresh blood in the stomach. The presence of teleangie...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1997-06-01 00:00:00
abstract::The application of Penicillamine (750 mg per day) for one year resulted in the expected increase of urinary copper excretion (8-10 fold). The increase of Zinc excretion was only moderate (2 fold). The application of Penicillamine did not influence the excretion of Ca, Mg and Fe. We did not find a decrease of Zinc cont...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00
abstract::35 out of 57 patients with gastric carcinoma presented with a so called "target" pattern. In cases with distal cancer the more advanced cases with endoscopic types Borrmann III/IV showed this sign more frequently than less advanced forms, i.e. suspected early cancer, Borrmann I or Borrmann II. On the other hand in end...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1984-02-01 00:00:00
abstract::Quantitative autoradiography was used to assess the densities of gamma-aminobutyric acid (GABAA) receptors in the brains of rats with a portacaval end-to-side shunt (PCA). The shunt alone induced only mild encephalopathy with ataxia and decreased locomotion. Aggravation of the encephalopathy was achieved by gavage fee...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::The German Health Care System (GHCS) faces many challenges among which an aging population and economic problems are just a few. The GHCS traditionally emphasised equity, universal coverage, ready access, free choice, high numbers of providers and technological equipment; however, real competition among health-care pr...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0032-1312742
更新日期:2012-06-01 00:00:00
abstract::Biological therapies in inflammatory bowel disease reflect the exponential advancement in understanding the human intestinal immune system and particularly the biology of intestinal inflammation during the past decade. The better understanding of the mechanisms of inflammatory bowel disease has evolved from desriptive...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2003-42924
更新日期:2003-10-01 00:00:00
abstract::Currently, evidence-based medicine is subject of a controversial discussion. This review is focused on the different types of evidence in clinical medicine and elaborates the history and context of evidence-based medicine. Evidence-based medicine insists that the theoretical plausibility of a therapeutical concept alo...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 历史文章,杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:The introduction of the S3 guideline on "Sedation in Gastrointestinal Endoscopy" in 2008 led to substantial organisational, structural, staffing-related, financial, and legal changes in the everyday work of departments of gastrointestinal endoscopy. This study examines the economic effects of this and the ch...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0032-1313080
更新日期:2012-09-01 00:00:00
abstract::Alpha 1-antitrypsin (alpha 1 AT) is a glycoprotein of hepatic origin which functions as a systemic protease inhibitor (Pi). Its production is controlled by two autosomal-codominantly transmitted alleles. Among the numerous genetic variants some alleles (predominantly PiZ) may induce alpha 1 AT-deficiency, facultativel...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:
更新日期:1982-07-01 00:00:00
abstract::Introduction and aims High-resolution esophageal manometry (HRM) has improved the diagnostic work-up of esophageal motility disorders. Simultaneous evaluation of bolus clearance delivers useful information about the function of tubular esophagus. We assessed bolus clearance in a combined HRM-impedance examination for ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0042-121267
更新日期:2017-02-01 00:00:00
abstract::The spontaneous course of the galactosamine-hepatitis in the guinea-pig (750 and 1000 mg/kg GalN iv respectively) is characterized by a terminal hypoglycemia together with hypothermia and arterial hypotension fifty-nine hours on average after GalN-application. Preventing hypoglycemia and hypothermia by continuous intr...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract::We prospectively compared esophageal and rectal motility data from 7 patients with progressive systemic sclerosis (4 females, 3 males) to esophageal recordings in 22 and anorectal recordings in 9 healthy controls. All patients with sclerosis exhibited motility disturbances in the lower esophageal sphincter (LES): LES ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1988-11-01 00:00:00