Publications by authors named "Henrik Junger"

Article Synopsis
  • Biliary fibrosis is a significant yet often overlooked aspect of liver and bile duct diseases, which can lead to serious health issues like organ failure.
  • Understanding the causes and development of biliary fibrosis is essential for improving prevention and treatment options for various biliary disorders.
  • The review highlights the clinical signs, demographics, and key cellular elements involved in biliary fibrosis, while also discussing crucial signaling pathways and future treatment strategies.
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  • Pediatric liver transplantations can sometimes require retransplantation (reLT) due to complications like graft failure, with 31 out of 208 patients needing this procedure between 2008 and 2021.
  • The study found that the main reasons for reLT included acute/chronic graft failure and complications like hepatic artery thrombosis, with a higher survival rate for patients undergoing multiple reLTs.
  • Successful outcomes are achievable in specialized centers, emphasizing the importance of careful selection and preoperative preparation for patients undergoing liver retransplantation.
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CD8 T lymphocytes are classically viewed as cytotoxic T cells. Whether human CD8 T cells can, in parallel, induce a tissue regeneration program is poorly understood. Here, antigen-specific assay systems revealed that human CD8 T cells not only mediated cytotoxicity but also promoted tissue remodeling.

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Article Synopsis
  • - The study investigates the impact of bile duct (BD) damage on long-term outcomes after liver transplantation, distinguishing between "major" BD damage and "no relevant" damage in 60 bile ducts.
  • - Patients with "major" BD damage showed significantly poorer survival rates over time, with specific early post-transplant markers like bilirubin levels and GGT/bilirubin ratios correlated to outcomes.
  • - High early GGT/bilirubin ratios may indicate potential regeneration and better survival chances, while major BD damage without regeneration markers suggests a need for future therapeutic interventions.
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In case of potential contamination, implantation of synthetic meshes in hernia and abdominal wall surgery is problematic due to a higher risk of mesh infection. As an alternative, a variety of different biologic meshes have been used. However, relevant data comparing outcome after implantation of these meshes are lacking.

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Background: After pediatric split liver transplantation, intra-abdominal loss of domain due to large-for-size left lateral grafts is a frequent problem for fascial closure and potentially leads to reduced liver perfusion and abdominal compartment syndrome. Therefore, delayed fascial closure with the use of temporary silastic meshes and reoperation or alternative fascial bridging procedures are necessary.

Methods: Between March 2019 and October 2021, biologic meshes were used for abdominal wall expansion in 6 cases of pediatric split liver transplantation.

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Background: Portal vein complications (PVCs) after pediatric liver transplantation (LT) are sometimes asymptomatic, especially in the early phase, and can threaten both the graft and patient's survival. Therefore, the purpose of this study is to analyze the risk factors for portal vein thrombosis (PVT) and portal vein stenosis (PVS) after pediatric LT.

Methods: All pediatric patients (n = 115) who underwent primary LT at Regensburg University Hospital between January 2010 and April 2017 were included in this study.

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Article Synopsis
  • Living donors can safely give part of their liver, especially the left side, but it can be risky for the person receiving it if it's too small for their body.
  • A new method called two-staged auxiliary liver transplantation helps make sure the liver fits well by first taking out a small part and waiting for the new liver piece to grow larger.
  • In this study, two patients did well with no problems, and their new livers grew enough to allow the doctors to remove the remaining old liver safely.
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Liver transplantation (LTx) is often the only possible therapy for many end-stage liver diseases, but successful long-term transplant outcomes are limited by multiple factors, including ischemia reperfusion injury (IRI). This situation is aggravated by a shortage of transplantable organs, thus encouraging the use of inferior quality organs. Here, we have investigated early hepatic IRI in a retrospective, exploratory, monocentric case-control study considering organ marginality.

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Background: Chronic hepatitis C virus (HCV) infection is characterized by activation of natural killer (NK) cells. Here, we asked whether HCV elimination by sofosbuvir-based direct-acting antivirals (DAAs) and the addition of ribavirin (RBV) improve NK cell function in liver transplant (LTx) recipients.

Methods: We analyzed NK cell degranulation and interferon (IFN)γ-response along with STAT1 and STAT4 phosphorylation in 29 HCV-infected LTx recipients and 17 HCV-infected patients during DAA treatment.

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Introduction: Open abdominal wounds with intestinal fistula formation are challenging complications in abdominal surgery. Special fistula devices (SFD) used along with negative pressure wound therapy with instillation and dwell time (NPWTi-d), may improve management of these wounds, increasing NPWT dressing durability and helping decrease dressing leakage.

Case Report: A 57-year-old, obese (body mass index: 55 kg/m²) female with a long history of Crohn disease and multiple intestinal resections, presented with an incarcerated parastomal hernia, abscess formation, and septic shock.

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Background: Incisional surgical site infections (iSSI) in hepatopancreatobiliary (HPB) surgery usually lead to prolonged hospital stays, consume valuable resources, and impact on patients' outcome. Prophylactic closed incision negative pressure wound therapy (ciNPWT) to decrease wound complications has become available. Owing to an increasing number of studies, evidence for superiority in many indication areas has accumulated; however, in general surgery, there are a few data and those have shown contradictory results.

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Article Synopsis
  • * In a study of patients from 2015 and 2016, SSIs were found in 13.5% of cases, with patients who developed SSIs experiencing longer hospital stays (an average of 19 extra days).
  • * The financial analysis revealed a significant loss for the hospital—€-7035.65 per SSI case—accumulating to a total deficit of €-802,064.62, indicating a need for better prevention measures and possible adjustments in hospital reimbursement rates.
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  • Belatacept shows better long-term outcomes compared to traditional calcineurin inhibitors (CNI) for organ transplant immunosuppression, but has higher rates of early T cell-mediated rejection (TCMR), affecting its overall adoption.
  • A study analyzed kidney biopsies from 92 patients, focusing on gene expression and inflammation to understand how belatacept affects immune responses compared to CNI treatment.
  • The findings revealed a strong correlation between TCMR gene expression and inflammatory levels, highlighting a unique impact of belatacept on myeloid cells and B-cell activity during early rejections.
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Article Synopsis
  • - The study introduces a new method called multiplex in situ hybridization (ISH) combined with immunofluorescence (IF), referred to as mIFISH, for better detection of cytokines in kidney transplant biopsies.
  • - mIFISH can pinpoint the cellular sources of key cytokines and chemokines and allows for the quantitative measurement of their expression at the single-cell level.
  • - This technique enhances understanding of immune responses and damage in transplanted kidneys, potentially leading to better diagnostics and treatment for transplant recipients.
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Article Synopsis
  • There is a pressing need for affordable and efficient methods to routinely assess transplant biopsies, utilizing existing collections of FFPE tissue from transplant centers to improve graft outcome predictions.* -
  • Researchers developed assays to evaluate 19 specific target genes in renal allograft biopsies to distinguish between stable graft function and acute rejection, using gene expression analysis from 163 biopsies and further validation with 40 additional samples.* -
  • The study compared two gene expression platforms (QPCR and NanoString), finding that increased expression levels from the target genes correlated with acute rejection and inflammation, providing a valuable tool for clinical assessment of kidney transplants.*
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Background: Anaplastic thyroid carcinomas are associated with rapid tumor growth, short survival time and without any promising therapy to improve the poor prognosis. In this study, expression of immunoregulative receptor CD1d and lymphocyte infiltration in different thyroid tumors as well as in healthy tissue were analyzed in order to find new targets for an immunotherapeutic approach.

Methods: CD1d immunohistochemistry was performed in samples of 18 anaplastic, 17 follicular, 27 papillary, and 4 medullary thyroid carcinomas as well as in 19 specimens from normal thyroid tissue and additionally in 10 samples of sarcoma, seven malignant melanoma and three spindle-cell lung carcinoma.

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Article Synopsis
  • Persistent HIV tissue reservoirs hinder efforts to find a cure, making it crucial to identify infected cell types in tissues.
  • The study introduces a new method combining multiplexed in situ hybridization (ISH) and immunofluorescence (IF) for detecting HIV DNA and RNA in human tissues, enabling precise assessment of infection.
  • The authors also explore how different tissue fixatives affect the detection of HIV signals and provide ways to quantify the results using digital imaging, aiming to enhance understanding of HIV reservoirs for future cure strategies.
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  • This study explored how epithelial repair and immune cell presence affect biliary complications in liver transplant patients, analyzing data from 41 individuals.
  • It found that damaged bile ducts (BDs) in patients without complications showed higher levels of key proteins (E-cadherin and cytokeratin) and a stronger immune response compared to those with complications.
  • The research suggests that better regenerative ability of biliary epithelium and a robust infiltration of adaptive immune cells may enhance recovery of bile ducts after cold storage, potentially predicting complications.
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Background & Aims: The aim of this study was to examine the development of biliary epithelial damage between organ retrieval and transplantation and its clinical relevance for patients.

Methods: Common bile duct samples during donor hepatectomy, after cold storage, and after reperfusion were compared to healthy controls by hematoxylin and eosin (H&E) staining and immunofluorescence for tight junction protein 1 and Claudin-1. A bile duct damage score to quantify biliary epithelial injury was developed and correlated with recipient and donor data and patient outcome.

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