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Wagener N, Nyarangi-Dix J, Teber D, Zeier M, Hohenfellner M. Applicability of Robot-Assisted Laparoscopic Radical Prostatectomy in Renal Allograft Recipients. Transplant Proc 2012; 44:1287-92. [DOI: 10.1016/j.transproceed.2012.01.120] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 01/18/2012] [Indexed: 10/28/2022]
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Cerini C, Gondouin B, Dou L, Duval-Sabatier A, Brunet P, Dignat- George F, Burtey S, Okano K, Okano K, Iwasaki T, Jinnai H, Hibi A, Miwa N, Kimata N, Nitta K, Akiba T, Dolley-Hitze T, Verhoest G, Jouan F, Arlot-Bonnemains Y, Lavenu A, Belaud-Rotureau MA, Rioux-Leclercq N, Vigneau C, Cox SN, Sallustio F, Serino G, Loverre A, Pesce F, Gigante M, Zaza G, Stifanelli P, Ancona N, Schena FP, Marc P, Jacques T, Green JM, Mortensen RB, Verma R, Leu K, Schatz PJ, Wojchowski DM, Ihoriya C, Satoh M, Sasaki T, Kashihara N, Jung YJ, Kang KP, Lee AS, Lee JE, Lee S, Park SK, Kim W, Kang KP, Florian T, Tepel M, Ying L, Katharina K, Nora F, Antje W, Alexandra S, Chiu YT, Wu MJ, Liu ZH, Liang Y, Zheng CX, Chen ZH, Zeng CH, Ranzinger J, Rustom A, Kihm L, Heide D, Scheurich P, Zeier M, Schwenger V, Liu J, Liu J, Zhong F, Xu L, Zhou Q, Hao X, Wang W, Chen N, Zhong F, Zhong F, Liu X, Zhou Q, Hao X, Lu Y, Guo S, Wang W, Lin D, Chen N, Vilasi A, Deplano S, Deplano S, Cutillas P, Unwin R, Tam FWK, Medrano-Andres D, Lopez-Martinez V, Martinez-Miguel P, Cano JL, Arribas I, Rodiguez-Puyol M, Lopez-Ongil S, Kadoya H, Nagasu H, Satoh M, Sasaki T, Kashihara N, Lindeberg E, Grundstrom G, Alexandra S, Tepel M, Katharina K, Alexandra M, Ghosh CC, David S, Mukherjee A, John SG, Mcintyre CW, Haller H, Parikh SM, Troyano N, Del Nogal M, Olmos G, Mora I, DE Frutos S, Rodriguez-Puyol M, Ruiz MP, Rothe H, Rothe H, Shapiro W, Ketteler M, Ramakrishnan SK, Loupy A, Houillier P, Guilhermino Pereira L, Boim M, Aragao D, Casarini D, Jin Y, Jin Y, Chen N, Moon JY, Kim YG, Lee SH, Lee TW, Ihm CG, Kim EY, Lee HJ, Wi JG, Jeong KH, Ruan XZ, LI LC, Varghese Z, Chen JB, Lee CT, Moorhead J, Dou L, Gondouin B, Cerini C, Poitevin S, Brunet P, Dignat-George F, Stephane B, Bonanni A, Verzola D, Maggi D, Brunori G, Sofia A, Mannucci I, Maffioli S, Salani B, D'amato E, Saffioti S, Laudon A, Cordera R, Garibotto G, Maquigussa E, Boim M, Arnoni C, Guilhermino Pereira L. Cell signalling / Pathophysiology. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Adamczak M, Koleganova N, Nyengaard JR, Ritz E, Wiecek A, Slabiak Blaz N, Yi Chun DX, Alexandre H, Sandrine GS, Olivier T, Isabelle E, Christophe L, Guy T, Pierre Francois W, Jean-Philippe R, Yvon L, Eric R, Muller-Krebs S, Muller-Krebs S, Weber L, Tsobaneli J, Reiser J, Zeier M, Schwenger V, Tinel C, Samson M, Bonnotte B, Mousson C, Machcinska M, Machcinska M, Bocian K, Wyzgal M, Korczak-Kowalska G, Ju MK, Huh KH, Park KT, Kim SJ, Cho BH, Kim CD, So BJ, Leee S, Kang CM, Joo DJ, Kim YS, Bocian K, Zarzycki M, Sobich A, Korczak-Kowalska G, Matsuyama M, Hase T, Yoshimura R, Koshino K, Sakai K, Suzuki T, Nobori S, Ushigome H, Brikci-Nigassa L, Chargui J, Touraine JL, Yoshimura N, Cantaluppi V, Medica D, Figliolini F, Migliori M, Mannari C, Dellepiane S, Quercia AD, Randone O, Tamagnone M, Messina M, Manzione AM, Ranghino A, Biancone L, Segoloni GP, Camussi G, Turk TR, Zou X, Rauen U, De Groot H, Amann K, Kribben A, Eckardt KU, Bernhardt WM, Witzke O, Lidia G, Wouter C, Yvon L, Eric A, Yann LM, Guy T, Christian N, Marie E, Pierre M, Zineb A, Miriana D, Annick M, Marc A, Daniel A, Wornle M, Ribeiro A, Motamedi N, Grone HJ, Cohen CD, Schlondorff D, Schmid H, Teplan V, Banas M, Banas B, Steege A, Bergler T, Kruger B, Schnulle P, Yard B, Kramer BK, Hoger S, Xavier MP, Sampaio-Norton S, Gaiao S, Alves H, Oliveira G, Xavier MP, Sampaio-Norton S, Gaiao S, Alves H, Oliveira G, Xavier MP, Sampaio-Norton S, Gaiao S, Alves H, Oliveira G, Zaza G, Rascio F, Pontrelli P, Granata S, Rugiu C, Grandaliano G, Lupo A, Wohlfahrtova M, Wohlfahrtova M, Brabcova I, Balaz P, Janousek L, Lodererova A, Honsova E, Wohlfahrt P, Viklicky O, Grabner A, Grabner A, Kentrup D, Edemir B, Sirin Y, Pavenstadt H, Schober O, Schlatter E, Schafers M, Schnockel U, Reuter S, Rascio F, Pontrelli P, Accetturo M, Gigante M, Gigante M, Tataranni T, Zito A, Schena A, Schena FP, Stallone G, Gesualdo L, Grandaliano G, Maillard N, Masson I, Lena A, Manolie M, Eric A, Christophe M, Lassen CK, Keller AK, Moldrup U, Bibby BM, Jespersen B, Cvetkovic T, Velickovic Radovanovic R, Pavlovic R, Djordjevic V, Vlahovic P, Stefanovic N, Sladojevic N, Ignjatovic A, Rong S, Menne J, Haller H, Suszdak P, Tomczuk P, Gueler F, Nelli S, Sara D, Salma EK, Naoufal M, Tarik M, Mohamed Z, Guislaine M, Mohamed Gharbi B, Benyounes R, Lu X, Rong S, Shushakova N, Menne J, Kirsch T, Haller H, Gueler F, Bockmeyer CL, Bockmeyer CL, Ramackers W, Wittig J, Agustian PA, Klose J, Dammrich ME, Kreipe H, Brocker V, Winkler M, Becker JU, Agustian PA, Bockmeyer CL, Wittig J, Becker JU, Bockmeyer CL. Transplantation - basic. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Fleming T, Cuny J, Nawroth G, Djuric Z, Humpert PM, Zeier M, Bierhaus A, Nawroth PP. Is diabetes an acquired disorder of reactive glucose metabolites and their intermediates? Diabetologia 2012; 55:1151-5. [PMID: 22270223 DOI: 10.1007/s00125-012-2452-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 12/13/2011] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS We hypothesised that diabetic patients would differ from those without diabetes in regard to the handling of glucose-derived reactive metabolites, evidenced by triosephosphate intermediates (TP(INT)) and methylglyoxal (MG), irrespective of the type of diabetes, plasma glucose level or HbA(1c) value. METHODS To test this hypothesis, erythrocytes were isolated from patients with type 1 (n = 12) and type 2 (n = 12) diabetes with varying blood glucose and HbA(1c) levels. These were then compared with erythrocytes isolated from individuals without diabetes (n = 10), with respect to MG, as determined by HPLC, and TP(INT), as determined by endpoint enzymatic assays. RESULTS The concentrations of intracellular TP(INT) and MG were significantly elevated in erythrocytes from diabetic patients. Normalisation of either TP(INT) or MG to intracellular glucose concentration (nmol glucose/mgHb) confirmed that erythrocytes from diabetic patients accumulated more reactive metabolites than did those from healthy controls. CONCLUSIONS/INTERPRETATION Diabetic patients can be characterised by an increased formation of TP(INT) and MG. The 25-fold increase of MG in type 1 and the 15-fold increase in type 2 diabetes, together with a several-fold increase in TP(INT) and decreased glyceraldehyde-3-phosphate dehydrogenase activity even under normal glucose conditions, imply that normalising glucose level cannot completely prevent late diabetic complications until this acquired error of metabolism has been restored.
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Steinborn A, Schmitt E, Kisielewicz A, Rechenberg S, Seissler N, Mahnke K, Schaier M, Zeier M, Sohn C. Pregnancy-associated diseases are characterized by the composition of the systemic regulatory T cell (Treg) pool with distinct subsets of Tregs. Clin Exp Immunol 2012; 167:84-98. [PMID: 22132888 DOI: 10.1111/j.1365-2249.2011.04493.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Dysregulations concerning the composition and function of regulatory T cells (T(regs)) are assumed to be involved in the pathophysiology of complicated pregnancies. We used six-colour flow cytometric analysis to demonstrate that the total CD4(+) CD127(low+/-) CD25(+) forkhead box protein 3 (FoxP3)(+) T(reg) cell pool contains four distinct T(reg) subsets: DR(high+) CD45RA(-), DR(low+) CD45RA(-), DR(-) CD45RA(-) T(regs) and naive DR(-) CD45RA(+) T(regs). During the normal course of pregnancy, the most prominent changes in the composition of the total T(reg) cell pool were observed between the 10th and 20th weeks of gestation, with a clear decrease in the percentage of DR(high+) CD45RA(-) and DR(low+) CD45RA(-) T(regs) and a clear increase in the percentage of naive DR(-) CD45RA(+) T(regs). After that time, the composition of the total T(reg) cell pool did not change significantly. Its suppressive activity remained stable during normally progressing pregnancy, but decreased significantly at term. Compared to healthy pregnancies the composition of the total T(reg) cell pool changed in the way that its percentage of naive DR(-) CD45RA(+) T(regs) was reduced significantly in the presence of pre-eclampsia and in the presence of preterm labour necessitating preterm delivery (PL). Interestingly, its percentage of DR(high+) CD45RA(-) and DR(low+) CD45RA(-) T(regs) was increased significantly in pregnancies affected by pre-eclampsia, while PL was accompanied by a significantly increased percentage of DR(-) CD45RA(-) and DR(low+) CD45RA(-) T(regs). The suppressive activity of the total T(reg) cell pool was diminished in both patient collectives. Hence, our findings propose that pre-eclampsia and PL are characterized by homeostatic changes in the composition of the total T(reg) pool with distinct T(reg) subsets that were accompanied by a significant decrease of its suppressive activity.
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Boeglin WU, Coman L, Ambrozewicz P, Aniol K, Arrington J, Batigne G, Bosted P, Camsonne A, Chang G, Chen JP, Choi S, Deur A, Epstein M, Finn JM, Frullani S, Furget C, Garibaldi F, Gayou O, Gilman R, Hansen O, Hayes D, Higinbotham DW, Hinton W, Hyde C, Ibrahim H, de Jager CW, Jiang X, Jones MK, Kaufman LJ, Klein A, Kox S, Kramer L, Kumbartzki G, Laget JM, LeRose J, Lindgren R, Margaziotis DJ, Markowitz P, McCormick K, Meziani Z, Michaels R, Milbrath B, Mitchell J, Monaghan P, Moteabbed M, Moussiegt P, Nasseripour R, Paschke K, Perdrisat C, Piasetzky E, Punjabi V, Qattan IA, Quéméner G, Ransome RD, Raue B, Réal JS, Reinhold J, Reitz B, Roché R, Roedelbronn M, Saha A, Slifer K, Solvignon P, Sulkosky V, Ulmer PE, Voutier E, Weinstein LB, Wojtsekhowski B, Zeier M. Probing the high momentum component of the deuteron at high Q2. PHYSICAL REVIEW LETTERS 2011; 107:262501. [PMID: 22243152 DOI: 10.1103/physrevlett.107.262501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Indexed: 05/31/2023]
Abstract
The (2)H(e,e'p)n cross section at a momentum transfer of 3.5 (GeV/c)(2) was measured over a kinematical range that made it possible to study this reaction for a set of fixed missing momenta as a function of the neutron recoil angle θ(nq) and to extract missing momentum distributions for fixed values of θ(nq) up to 0.55 GeV/c. In the region of 35°≤θ(nq)≤45° recent calculations, which predict that final-state interactions are small, agree reasonably well with the experimental data. Therefore, these experimental reduced cross sections provide direct access to the high momentum component of the deuteron momentum distribution in exclusive deuteron electrodisintegration.
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Kunze R, Witt S, Vienken J, Rie K, Masayoshi N, Aritoshi K, Yoshinaga O, Yukiko H, Takahiro K, Hiroshi N, Takeshi N, Aoki S, Makino J, Noguchi M, Yamasaki F, Toda S, Santiago J, Caparros G, Vozmediano C, Molina F, Javier L, Sara A, Minerva A, Romera A, Kihm L, Diekmann C, Seckinger J, Sommerer C, Morath C, Zeier M, Schwenger V, Teixeira L, Rodrigues A, Carvalho MJ, Cabrita A, Mendonca D. Peritoneal dialysis. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wornle M, Ribeiro A, Motamedi N, Nitschko H, Cohen CD, Grone HJ, Schlondorff D, Schmid H, Kislat C, Schmidt T, Janssen M, Wolf M, Dirks J, Ahlenstiel T, Pape L, Fliser D, Sester M, Sester U, Urbanova M, Brabcova I, Girmanova E, Ondrej V, Gregorini M, Rampino T, Rocca C, Valsania T, Corradetti V, Bosio F, Bedino G, Carrara C, Pattonieri EF, Soccio G, Esposito P, Dal Canton A, Becker LE, Morath C, Schaier M, Gross ML, Bierhaus A, Waldherr R, Nawroth P, Zeier M, Tataranni T, Biondi G, Cariello M, Mangino M, Colucci G, Rutigliano M, Ditonno P, Schena FP, Pertosa G, Gesualdo L, Grandaliano G. Transplantation / Basic research. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kihm LP, Zeier M, Morath C. Immunosuppression after kidney transplantation. MINERVA UROL NEFROL 2011; 63:45-57. [PMID: 21336245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Today kidney transplantation features excellent short-term outcomes with decreasing acute rejection episodes. In contrast, improvement of long-term allograft survival is much less impressive over the last decades. Thus, the goal of current immunosuppressive therapies is keeping the balance between the reduction of acute rejection episodes and organ specific and systemic side effects. With the development of a broad armamentarium of new immunosuppressive agents with different mechanisms of action, the minimization or avoidance of corticosteroids and calcineurin inhibitors became feasible.
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Goldwasser R, Tönshoff B, Zeier M. Epidemiologie und Prävalenz von Hantavirus-Infektionen bei pädiatrischen Patienten in Deutschland 2001-2010. KLINISCHE PADIATRIE 2011. [DOI: 10.1055/s-0031-1273880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Seckinger J, Tönshoff B, Stremmel W, Zeier M, Schmidt J. Die kombinierte und sequentielle Leber-Nieren-Transplantation. Dtsch Med Wochenschr 2010. [DOI: 10.1055/s-0030-1248660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Seckinger J, Tönshoff B, Stremmel W, Zeier M, Schmidt J. Die kombinierte und sequentielle Leber-Nieren-Transplantation. Dtsch Med Wochenschr 2010; 135:1973-8. [DOI: 10.1055/s-0030-1263345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Slifer K, Rondón OA, Aghalaryan A, Ahmidouch A, Asaturyan R, Bloch F, Boeglin W, Bosted P, Carasco C, Carlini R, Cha J, Chen JP, Christy ME, Cole L, Coman L, Crabb D, Danagoulian S, Day D, Dunne J, Elaasar M, Ent R, Fenker H, Frlez E, Gaskell D, Gan L, Gomez J, Hu B, Jourdan J, Jones MK, Keith C, Keppel CE, Khandaker M, Klein A, Kramer L, Liang Y, Lichtenstadt J, Lindgren R, Mack D, McKee P, McNulty D, Meekins D, Mkrtchyan H, Nasseripour R, Niculescu I, Normand K, Norum B, Pocanic D, Prok Y, Raue B, Reinhold J, Roche J, Kiselev D, Savvinov N, Sawatzky B, Seely M, Sick I, Smith C, Smith G, Stepanyan S, Tang L, Tajima S, Testa G, Vulcan W, Wang K, Warren G, Wesselmann FR, Wood S, Yan C, Yuan L, Yun J, Zeier M, Zhu H. Probing quark-gluon interactions with transverse polarized scattering. PHYSICAL REVIEW LETTERS 2010; 105:101601. [PMID: 20867509 DOI: 10.1103/physrevlett.105.101601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2009] [Revised: 08/24/2010] [Indexed: 05/29/2023]
Abstract
We have extracted QCD matrix elements from our data on doubly polarized inelastic scattering of electrons on nuclei. We find the higher twist matrix element d˜2, which arises strictly from quark-gluon interactions, to be unambiguously nonzero. The data also reveal an isospin dependence of higher twist effects if we assume that the Burkhardt-Cottingham sum rule is valid. The fundamental Bjorken sum rule obtained from the a0 matrix element is satisfied at our low momentum transfer.
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Fonouni H, Golriz M, Mehrabi A, Oweira H, Schmied BM, Müller SA, Jarahian P, Tahmasbi Rad M, Esmaeilzadeh M, Tönshoff B, Weitz J, Büchler MW, Zeier M, Schmidt J. The role of an interdisciplinary transplant team on living donation kidney transplantation program. Transplant Proc 2010; 42:137-40. [PMID: 20172299 DOI: 10.1016/j.transproceed.2009.12.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
During the last decades, the disparity between the organ supply and the demand for kidney transplantation in Europe has led to consider living donors as a more acceptable option. In the last 7 years, we have established an interdisciplinary supporting transplant team to increase the rate of living donation. After 2001, the new interdisciplinary transplant team consisted of a transplant surgeon, a nephrologist, a pediatrician, a radiologist, a psychologist, a transplant coordinator, and a transplant nurse. We performed a prospective analysis to examine the effect of implementing this team on our living donation program. Demographic data, the annual number of procedures, the duration of waiting, and the cold ischemia time were evaluated among brain-dead and living donors. From January 2002 until December 2008, the number of patients who were annually on the waiting list increased 42% (from 377 to 536 patients). Consequently, the number of the total kidney transplants increased from 81 to 120 with an annual median of 98 cases. By implementing the interdisciplinary transplant team, a significant increase of living kidney donors was observed: from 18 to 42 cases; median = 27). In the last 7 years, a total number of 796 kidney transplants have been performed: 567 from brain-dead and 229 from living donors. In 2001, the waiting list times for recipients who received grafts from brain-dead versus living donors were 1356 versus 615 days respectively. Compared with 2008, the duration on the waiting list decreased significantly for patients receiving a living donor graft, whereas there was a slight increase for the patients in the brain-dead group: brain death versus living donors: 1407 versus 305 days. The interdisciplinary approach has also reduced the cold ischemia time for the living donor recipients: 3 hours and 42 minutes in 2001 versus 2 hours and 50 minutes in 2008. During the last years, by implementing an interdisciplinary transplant team, supporting living donor procedures has produce a gradual increase in the number of kidney transplants from living donors with a remarkable decrease in waiting and cold ischemia times, the latter presumably influencing graft quality.
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Mehrabi A, Fonouni H, Ayoub E, Rahbari NN, Müller SA, Morath C, Seckinger J, Sadeghi M, Golriz M, Esmaeilzadeh M, Hillebrand N, Weitz J, Zeier M, Büchler MW, Schmidt J, Schmied BM. A single center experience of combined liver kidney transplantation. Clin Transplant 2010; 23 Suppl 21:102-14. [PMID: 19930323 DOI: 10.1111/j.1399-0012.2009.01146.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
With advancements in the operative techniques, patient survival following liver transplantation (LTx) has increased substantially. This has led to the acceleration of pre-existing kidney disease because of immunosuppressive nephrotoxicity making additional kidney transplantation (KTx) inevitable. On the other hand, in a growing number of patients on the waiting list to receive liver, long waiting time has resulted in adverse effect of decompensated liver on the kidney function. During the last two decades, the transplant community has considered combined liver kidney transplantation (CLKTx) to overcome this problem. The aim of our study is to present an overview of our experience as well as a review of the literature in CLKTx and to discuss the controversy in this regard. All performed CLKTx (n = 22) at our institution as well as all available reported case series focusing on CLKTx are extracted. The references of the manuscripts were cross-checked to implement further articles into the review. The analyzed parameters include demographic data, indication for LTx and KTx, duration on the waiting list, Model for End-Stage Liver Disease (MELD) score, Child-Turcotte-Pugh (CTP) score, immunosuppressive regimen, post-transplant complications, graft and patient survival, and cause of death. From 1988 to 2009, a total of 22 CLKTx were performed at our institution. The median age of the patients at the time of CLKTx was 44.8 (range: 4.5-58.3 yr). The indications for LTx were liver cirrhosis, hyperoxaluria type 1, polycystic liver disease, primary or secondary sclerosing cholangitis, malignant hepatic epithelioid hemangioendothelioma, cystinosis, and congenital biliary fibrosis. The KTx indications were end-stage renal disease of various causes, hyperoxaluria type 1, polycystic kidney disease, and cystinosis. The mean follow-up duration for CLKTx patients were 4.6 +/- 3.5 yr (range: 0.5-12 yr). Overall, the most important encountered complications were sepsis (n = 8), liver failure leading to retransplantation (n = 4), liver rejection (n = 3), and kidney rejection (n = 1). The overall patient survival rate was 80%. Review of the literature showed that from 1984 to 2008, 3536 CLKTx cases were reported. The main indications for CLKTx were oxalosis of both organs, liver cirrhosis and chronic renal failure, polycystic liver and kidney disease, and liver cirrhosis along with hepatorenal syndrome (HRS). The most common encountered complications following CLKTx were infection, bleeding, biliary complications, retransplantation of the liver, acute hepatic artery thrombosis, and retransplantation of the kidney. From the available data regarding the need for post-operative dialysis (n = 673), a total of 175 recipients (26%) required hemodialysis. During the follow-up period, 154 episodes of liver rejection (4.3%) and 113 episodes of kidney rejection (3.2%) occurred. The cumulative 1, 2, 3, and 5 yr survival of both organs were 78.2%, 74.4%, 62.4%, and 60.9%, respectively. Additionally, the cumulative 1, 2, 3, and 5 yr patient survival were 84.9%, 52.8%, 45.4%, and 42.6%, respectively. The total number of reported deaths was 181 of 2808 cases (6.4%), from them the cause of death in 99 (55%) cases was sepsis. It can be concluded that there is still no definitive evidence of better graft and patient survival in CLKTx recipients when compared with LTx alone because of the complexity of the exact definition of irreversible kidney function in LTx candidates. Additionally, CLKTx is better to be performed earlier than isolated LTx and KTx leading to the avoidance of deterioration of clinical status, high rate of graft loss, and mortality. Shorter graft ischemia time and more effective immunosuppressive regimens can reduce the incidence of graft malfunctioning in CLKTx patients. Providing a model to reliably determine the need for CLKTx seems necessary. Such a model can be shaped based upon new and precise markers of renal function, and modification of MELD system.
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Beimler J, Zeier M. Borderline rejection after renal transplantation--to treat or not to treat. Clin Transplant 2010; 23 Suppl 21:19-25. [PMID: 19930312 DOI: 10.1111/j.1399-0012.2009.01105.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
According to the Banff classification of renal allograft pathology, the category borderline changes defines changes insufficient for a diagnosis of acute rejection. The relationship between borderline changes and acute renal allograft rejection still remains unclear. The appropriate clinical management for patients showing such changes is controversial. One possible interpretation of the high incidence of subacute tubulitis is that these changes in the absence of graft dysfunction are of no consequence and that treatment with intensified immunosuppression is unnecessary and perhaps harmful. Another view, consistent with the high incidence of CAN in late protocol biopsy studies, is that immunosuppression has become so powerful, that rejection may not even be manifested by a rising serum creatinine. Borderline changes should be used as part of an algorithm, but not as the only criterion, for therapeutic decision making. Based on the weak evidence of existing studies, in our patients with clinical borderline rejection, we have to weigh the individual immunological risk against the potential side effects of increased immunosuppression. Even in the knowledge that a majority of patients with borderline infiltrates will not progress into rejection, in many transplant centers, borderline rejection is treated with additional steroids or augmentation of maintenance immunosuppression.
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Büchler MW, Fonouni H, Mehrabi A, Schmidt J, Zeier M. Innovations in transplantation Medicine. Introduction. Clin Transplant 2009; 23 Suppl 21:1. [PMID: 19930308 DOI: 10.1111/j.1399-0012.2009.01101.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Morath C, Schmied B, Mehrabi A, Weitz J, Schmidt J, Werner J, Buchler M, Morcos M, Nawroth P, Schwenger V, Doehler B, Opelz G, Zeier M. Angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor blockers after renal transplantation. Clin Transplant 2009; 23 Suppl 21:33-6. [DOI: 10.1111/j.1399-0012.2009.01107.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Brost S, Wenzel JJ, Ganten TM, Filser M, Flechtenmacher C, Boehm S, Astani A, Jilg W, Zeier M, Schnitzler P. Sporadic cases of acute autochthonous hepatitis E virus infection in Southwest Germany. J Clin Virol 2009; 47:89-92. [PMID: 19910247 DOI: 10.1016/j.jcv.2009.10.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 10/05/2009] [Accepted: 10/07/2009] [Indexed: 02/03/2023]
Abstract
Hepatitis E infection is usually a self-limiting disease and an important cause of acute hepatitis in tropical and subtropical regions where the virus is endemic. In industrialized countries, sporadic cases of acute hepatitis E virus (HEV) infections have been described and the number of documented autochthonous infections seems to be increasing. We report three sporadic cases of autochthonous hepatitis E infections in Southwestern Germany which presented at our university hospital within two years. All cases were men who presented with acute hepatitis, icterus and elevated liver. In case 1 and case 2, liver biopsy revealed acute hepatitis, both patients were positive for anti-HEV antibodies, case 1 was also positive for HEV RNA with a viral load of 3.0 x 10(3)copies/ml in serum. In case 3, anti-HEV antibodies were detectable and HEV RNA was detected in serum (4.3 x 10(3)copies/ml) and stool (1.4 x 10(6)copies/ml). None of the patients had a recent travel history outside Germany and close contact to animals has been denied. HEV sequence analysis of two patients revealed genotype 3 with homologies to other European isolates and isolates from swine. Thus the source of infection remains unclear. Hepatitis E should be considered in differential diagnosis in patients with unexplained hepatitis and patients with acute hepatitis, whatever their age or travel history might be, should be tested for HEV.
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Morath C, Schmied B, Mehrabi A, Weitz J, Schmidt J, Werner J, Buchler M, Morcos M, Nawroth P, Schwenger V, Doehler B, Opelz G, Zeier M. Simultaneous pancreas-kidney transplantation in type 1 diabetes. Clin Transplant 2009; 23 Suppl 21:115-20. [DOI: 10.1111/j.1399-0012.2009.01116.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Trivedi S, Zeier M, Reiser J. Role of podocytes in lupus nephritis. Nephrol Dial Transplant 2009; 24:3607-12. [DOI: 10.1093/ndt/gfp427] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Steen H, Schwenger V, Ritz E, Zeier M. Reply. Nephrol Dial Transplant 2009. [DOI: 10.1093/ndt/gfp043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Furkert J, Zeier M, Schwenger V. CAPD: developments during changing times. Perit Dial Int 2009; 29:115-116. [PMID: 19164262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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Domhan S, Zeier M, Abdollahi A. Immunosuppressive therapy and post-transplant malignancy. Nephrol Dial Transplant 2008; 24:1097-103. [DOI: 10.1093/ndt/gfn605] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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