Air Repatriation With a Medium-sized Pneumothorax Without Thoracic Tube: A Special Case of a Repatriation Accompanied by an Experienced Surgeon.

We report on the repatriation of a 28-year old female from Germany, who was involved in a serious bus accident and was transported to the nearest hospital in Oruro, Bolivia. CT scans and x-rays performed in this hospital demonstrated a complete pneumothorax right. Thorax drainage was inserted, which was removed after 5 days.

Donor desmopressin is associated with superior graft survival after kidney transplantation.

Background: A recent randomized trial showed that pretreatment of the brain-dead donor with low-dose dopamine improves immediate kidney graft function, by limiting injury from cold storage (ClinicalTrials.gov Identifier: NCT00115115). This study determines whether donor exposure to desmopressin (1-deamino-8-d-arginine-vasopressin [DDAVP]) before organ retrieval affects renal transplant outcome.

Effects of donor pre-treatment with dopamine on survival after heart transplantation: a cohort study of heart transplant recipients nested in a randomized controlled multicenter trial.

Objectives: We determined the outcome of cardiac allografts from multiorgan donors enrolled in a randomized trial of donor pre-treatment with dopamine.

Background: Treatment of the brain-dead donor with low-dose dopamine improves immediate graft function after kidney transplantation.

Methods: A cohort study of 93 heart transplants from 21 European centers was undertaken between March 2004 and August 2007.

The need for vigilance in extended criteria donors with a past history of malignancy: a case report and review of literature.

Background: Organ shortage has prompted many transplant centers to extend their criteria for organ acceptance including the history of a variety of co-morbidities in donors. The use of organs from donors with a past medical history of malignancy in order to reduce the waiting list mortalities remains a dilemma.

Case Report: Herein we report a 62-year-old female donor with a history of a presumably cured serous adenocarcinoma of the ovary and underscore the need for vigilance in the search of an active site of cancer while assessing these donors for organ recovery.

Effects of donor pretreatment with dopamine on graft function after kidney transplantation: a randomized controlled trial.

Context: Kidney graft function after transplantation can be improved through pharmacological donor pretreatment to limit organ injury from cold preservation.

Objective: To determine whether pretreatment of brain-dead donors with low-dose dopamine improves early graft function in human renal transplant recipients.

Design, Setting, And Patients: Randomized, open-label, multicenter, parallel-group trial of 264 deceased heart-beating donors and 487 subsequent renal transplants performed at 60 European centers between March 2004 and August 2007 (final follow-up, December 31, 2008).

Detection of potential organ donors: 2-year analysis of deaths at a German university hospital.

Objective: In 2006, inhouse coordinators were introduced in all hospitals with intensive care units in Baden-Württemberg to improve organ donation. At our university hospital with a neurosurgery and a transplantation unit, we analyzed whether brain death certification and donation requests were always initiated (if possible).

Materials And Methods: We retrospectively reviewed all 1312 hospital deaths from 2006-2007 by studying medical records and consulting with physicians.

Expanded criteria liver donors (ECD): effect of cumulative risks.

Unlabelled: The use of ECD in liver donors increases the risk of primary non function (PNF). The German Medical Association (2004) defined an ECD, if one of the following conditions existed: high risk of disease transmission, hemodynamic deterioration, donor age > 65years, BMI > 30kg/m2, bilirubine > 51 mmol/l, ASAT or ALAT > 3*reference, sodium > 165 mmol/l, days on ICU > 7, steatosis > 40% or equivalent liver pathologies. The effect of ECD-criteria was assessed.

[Chemoembolization of hepatocellular carcinomas: which factors determine therapeutic response and survival?].

Purpose: To determine independent prognostic factors influencing the survival of patients with hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization (TACE).

Materials And Methods: Ninety-one patients with unresectable HCC were treated with 269 repetitive TACE. The dosages of epirubicin (40-60 mg) and ethiodized oil (8-20 ml) were adjusted to tumor size and liver function.

Influence of perioperative sHLA I concentrations on the histological development of the liver graft.

Soluble HLA I (sHLA I) in human serum are ascribed an immunoregulatory role in the context of organ transplantation. Based on histological findings, the objective of the current study was to evaluate the protective influence of sHLA I in liver transplantation from the time point of reperfusion. The sHLA I concentrations in serum samples derived from the liver vein immediately after reperfusion (flush catheter) of 38 patients with liver transplantations were determined by ELISA.

The quality of a liver graft.

Because transplantation success is influenced by the quality of the graft, the objective of this study was to find parameters to evaluate transplant livers in the recipient centre. In 64 liver grafts, the venous effluates of a portal back-table flush were investigated for various parameters. Amongst them, glutathione S-transferase (GST), glutamate dehydrogenase (GLDH) and the leucocyte count were found superior in predicting graft survival.

Endotoxemia in organ donors: graft function following liver transplantation.

Translocation of endotoxin (LPS) to the portal-venous system is produced by multiple factors. In the case of normal liver function, LPS is rapidly cleared from the portal blood by Kupffer cells; in impaired liver function, LPS can reach the systemic circulation. The objective of this study was to investigate whether elevated donor endotoxin levels affect graft function in the recipient.

MR imaging and (1)H spectroscopy of brain metabolites in hepatic encephalopathy: time-course of renormalization after liver transplantation.

Purpose: To evaluate changes in hydrogen 1 magnetic resonance (MR) spectroscopic findings in overt or subclinical hepatic encephalopathy (HE) after liver transplantation and to compare these changes with clinical outcomes and basal ganglia high signal intensity (BGH).

Materials And Methods: Twenty-two patients scheduled for liver transplantation and 17 healthy control subjects were examined with (1)H MR spectroscopy and standard nonenhanced MR imaging. Eight patients underwent complete MR imaging and (1)H spectroscopic examinations before liver transplantation and at 3-4-week, 12-28-week, and 10-12-month follow-up after liver transplantation.

Improvement of hepatorenal syndrome with extracorporeal albumin dialysis MARS: results of a prospective, randomized, controlled clinical trial.

In hepatorenal syndrome (HRS), renal insufficiency is often progressive, and the prognosis is extremely poor under standard medical therapy. The molecular adsorbent recirculating system (MARS) is a modified dialysis method using an albumin-containing dialysate that is recirculated and perfused online through charcoal and anion-exchanger columns. MARS enables the selective removal of albumin-bound substances.

Molecular adsorbent recycling system (MARS): clinical results of a new membrane-based blood purification system for bioartificial liver support.

The use of xenogenic or genetically engineered cell types in bioartificial liver support systems requires separation methods between the patients' blood and the liver support bioreactors that guarantee the sufficient transfer of pathophysiologically relevant substances but prevent complications. The present paper describes a new membrane separation system that is nearly impermeable to proteins but enables the exchange of water soluble and protein bound toxins by a special membrane and a recycled protein containing dialysate. Because the full range of toxins in hepatic failure has still not been identified, the value of this membrane separation method was evaluated clinically.

Introducing fluorine-18 fluoromisonidazole positron emission tomography for the localisation and quantification of pig liver hypoxia.

Fluorine-18 labelled fluoromisonidazole ([18F]FMISO) has been shown to accumulate in hypoxic tissue in inverse proportion to tissue oxygenation. In order to evaluate the potential of [18F]FMISO as a possible positron emission tomography (PET) tracer for imaging of liver tissue hypoxia, we measured the [18F]FMISO uptake in 13 domestic pigs using dynamic PET scanning. Hypoxia was induced by segmental arterial hepatic occlusion.

Diagnosis and management of metastatic gastrinoma by multimodality treatment including liver transplantation: report of a case.

Neuroendocrine tumors of the pancreas are being recognized with increasing frequency, not because the incidence has increased, but as a result of improvements in diagnostic tools such as radioimmunoassays for a variety of circulating peptides, and imaging methods that include positron emission tomography (PET) and immunoscintigraphy. Nevertheless, establishing the diagnosis of a neuroendocrine tumor is always a challenge to the clinician from both diagnostic and therapeutic perspectives. Liver transplantation as the ultimate therapeutic, or at least palliative, option for hepatic metastases has produced contradictory results over the past decade.

The radiological management of biliary complications following liver transplantation.

Purpose: Biliary complications contribute significantly to morbidity and mortality in the liver transplant recipient. Surgery has been the mainstay of therapy, but interventional radiological techniques have made significant progress.

Methods: Diagnostic percutaneous transhepatic cholangiography (PTC) was performed in 12 patients; percutaneous transhepatic drainage (PTD) was performed in 10 patients.

[Does piggy-back liver transplantation have a detrimental effect on venous drainage?--A comparative duplex ultrasound study].

Venous drainage in "Piggy-back" Liver Transplantation "Piggy-back" orthotopic liver transplant (OLT) may offer some advantages (hemodynamic stability without veno-venous bypass) over standard OLT, but there is concern about the risk of venous outflow obstruction associated with this technique. In this study (n = 19 piggy-back, n = 12 standard OLT) it was possible to show, by means of duplex scanning, that flow velocity, resistance and flow of hepatic veins do not differ significantly.

[Liver transplantation 1994].

Transplantation of the liver has progressed in recent years and has become universally accepted for numerous indications in end-stage liver diseases, predominantly primary biliary cirrhosis, sclerosing cholangitis, biliary atresia and liver-related metabolic disorders. In fulminant and subfulminant hepatitis, prognosis has been improved considerably by liver transplantation. The debate still persists whether liver transplantation might be indicated in diseases recurring after transplantation, such as HBV cirrhosis.