Experiences with Liver Transplantation in Hannover

Pichlmayr, R.; Brölsch, Ch.; Wonigeit, K.; Neuhaus, P.; Siegismund, S.; Schmidt, Frederick W.; Burdelski, M.

doi:10.1002/hep.1840040716

Cited by 46 publications

(13 citation statements)

References 4 publications

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“…Hepatocellular carcinoma (HCC) is one of the world's most common malignant diseases, with an annual incidence of one million cases. It is widespread in the Orient and sub-Saharan Africa, and an increasing incidence in Western countries has recently been noted, mainly related Orthotopic liver transplantation (OLT) has been used in the treatment of primary liver cancer for over 30 years [2], but its role remains controversial, with high recurrence rates varying from 40 to 75 % [3] and survival times rarely exceeding 2 years [4]. Several factors such as I S 205 various histologic types of malignancies or the presence of micrometastases have been advocated in order to explain the different survival rates after OLT.…”

Section: Introductionmentioning

confidence: 99%

Role of immunosuppression in recurrence after liver transplantation for diethylnitrosamine-induced tumors in rats

et al. 1994

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Hepatocellular carcinoma is one of the world's most common malignant diseases, with an increasing incidence related to liver cirrhosis. The purpose of the study was to evaluate the role of immunosuppression in recurrence in rats transplanted after liver tumor induction by diethylnitrosamine (DENA), which has proved to be a reliable carcinogen. In 14-week-old Lewis rats weighing 200 g, tumors were induced by the oral administration (5 mg/100 ml in drinking water ad libitum) of DENA for 13 weeks. Orthotopic liver transplantation (OLT) was performed after 4 weeks' latency. In the Lewis/Lewis rats weighing 200 g, tumors sporin A (CsA) treatment, median survival was 199-days with no recurrence or metastasis. In the BN/Lewis group with no CsA (5 ats) median survival was 144 days. All rats died due to rejection. In the other BN/Lewis group (10 rats), OLT was followed by CsA administration (7.5 mg/kg). Median survival was 161 days. In three rats (218 days), there was liver tumor recurrence; in two rats (137.5 days), kidney and lung metastases were found. The remaining rats died of septic complications. In the Lewis/Lewis + CsA group (10 rats), median survival was 131 days with 5 recurrencies and/or metastases. Two rats are still surviving at 84 and 88 days. Our results suggest that the DENA model is reliable; it proved to have a similar carcinologic pattern to HCC in man. Moreover, immunosuppression seems to play an important role in determining recurrence. Further studies are needed to investigate the efficacy of chemotherapy agents pre- and post-transplantation.

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Section: Introductionmentioning

confidence: 99%

Role of immunosuppression in recurrence after liver transplantation for diethylnitrosamine-induced tumors in rats

et al. 1994

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“…During the early years of liver grafting, almost 1 of 3 transplant recipients had a malignant condition. [38][39][40] The radical nature of total hepatectomy and liver replacement was appealing from an oncological perspective, but it proved to be biologically inadequate treatment for most malignancies. Most patients died of recurrent malignancy within 2 years, with the lungs and liver graft frequent sites of recurrence.…”

Section: Hcc Without Cirrhosismentioning

confidence: 99%

Surgery and transplantation for hepatocellular cancer

Wall¹,

Marotta

2000

Liver Transpl

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“…The first successful pLTx in Germany was performed by Pichlmayr et al. in Hannover (1978) (1). Subsequently, Berlin (2) (1988), Hamburg (3) (1989) and Essen (4) (1998) established pLTx programs.…”

mentioning

confidence: 99%

A new pediatric liver transplantation program in Southern Germany. The Heidelberg experience

Engelmann

Schmidt

Weitz

et al. 2010

Pediatric Transplantation

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pLTx is a highly complex procedure. It can only be performed safely by experienced teams. Starting a new pLTx program in a country with established centers must therefore avoid a learning curve. We have initiated a liver transplantation program for children in 2003. Medical standards were defined by a team of surgeons, pediatricians, radiologists, anesthesiologists, and pathologists before the first transplantation. An external expert in the field of pLTx supervised the whole process. In a pilot phase, six children weighing more than 20 kg were successfully transplanted. Following this series, the clinical pathways were re-evaluated, and the program was opened for children of all age groups. Between 2003 and 2008, 32 children received 34 organs. Sixty-eight percent of patients received a split-liver, 26% a full size organ, and 6% a reduced size graft. Four LRLTx were performed. Patient survival rate was 91%. We conclude that a new pLTx program can be established without a significant learning curve regarding mortality if a strict strategy of team-building is followed. In the pilot phase, small children and infants have to be referred and transplanted in an established center. An interdisciplinary team of specialists closely working together is the key for sustained success.

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Experiences with Liver Transplantation in Hannover

Cited by 46 publications

References 4 publications

Role of immunosuppression in recurrence after liver transplantation for diethylnitrosamine-induced tumors in rats

Role of immunosuppression in recurrence after liver transplantation for diethylnitrosamine-induced tumors in rats

Surgery and transplantation for hepatocellular cancer

A new pediatric liver transplantation program in Southern Germany. The Heidelberg experience

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