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  • Articles: DFG German National Licenses  (3)
  • Liver transplantation  (2)
  • AV nodal cells  (1)
  • 1
    ISSN: 1432-2307
    Keywords: AV nodal cells ; Working myocardium ; Cardiac arrest and global ischaemia ; HTK cardioplegia ; Qualitative and quantitative ultrastructure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The cardiac conduction system is considered to be particularly resistant to ischaemia. Nevertheless, following open heart surgery with short periods of ischaemia disturbances in AV conduction or ventricular arrhythmia have been reported. We compared the ultrastructure of AV node and working myocardium following 30 min global ischaemia at 25° C, during pure ischaemia and with HTK cardioplegia qualitatively and morphometrically. After 30 min of pure ischaemia, interstitial and intracellular oedema together with considerable changes in organelles in AV nodes predominate over mainly cellular oedema in working myocardium. Sometimes irregular overcontractions of sarcomeres occur in the AV node, though very seldom in working myocardium. In pure ischaemia, mitochondrial swelling is comparable in both types of tissue. Following HTK cardioplegia and 30 min ischaemia, cellular oedema and mitochondrial swelling are significantly reduced in AV nodal cells and working myocardium, but remain more extensive in the AV nodes. Irregularities in the contractile state of sarcomeres are not observed. The extent of the ultrastructural alterations corresponds to the degree of metabolic change in the working myocardium. Thus, despite considerable differences during pure ischaemia and HTK cardioplegia, ultrastructurally the AV nodal cells do not display a greater resistance to ischaemia than working myocardium.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2277
    Keywords: HTK solution ; UW solution, liver preservation ; Liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Over a 30-month period, 60 patients (30 in each group) suffering from end-stage liver disease or primary hepatic malignancy and scheduled for liver transplantation were enrolled in a prospective, randomized study to compare two methods of liver preservation: histidinetryptophan-ketoglutarate (HTK) solution versus University of Wisconsin (UW) solution. Entry criteria for both groups were: age (18–65 years), elective surgery (transplantable or urgent category of the recipients), first transplantations and harvesting procedure performed by the same team. The parameters under investigation were the clinical and laboratory data preand post-transplantation, as well as follow-up data such as complications and survival. There were no significant differences in the two groups as far as the evaluation criteria were concerned, even when cold ischemia time was more than 15h (n=7). A slight, yet not significant, increase in late complications of the biliary anastomoses could be seen in the UW group. Hepatocellular injury (SGOT, SGPT, GLDH, lactate) appeared to be more marked in the HTK group. These results suggest that both HTK and UW solutions are appropriate for clinical use in liver transplantation, even if cold ischemia time is more than 15h.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1435-2451
    Keywords: Electrical impedance ; Liver ischemia ; Liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 22 Lebern, die zur Transplantation beim Menschen perfundiert und entnommen wurden, wurde das Verfahren der nichtinvasiven Messung der bioelektrischen Impedanz prospektiv angewendet. Im Verlauf der Messung sollten Rückschlüsse auf einen möglichen Ischamieschaden der Organe gezogen wurden. Die Meßwerte wurden zur Funktion der Lebern, den Ischämiezeiten und den Konservierungsverfahren in Beziehung gesetzt. Für die Impedanz ergaben sich in vivo bei 192 Hz im Mittel 620 Ohm, für den Phasenwinkel bei 5 kHz −7,4°. Diese Werte entsprachen denen eines Kollektivs von 72 lebergesunden Patienten (mittels Multivarianz aus einem untersuchten Kollektiv von 132 Patienten ermittelt), die intraoperativ durchgeführt wurden. Die 22 Transplantatlebern wurden in den Ischämiephasen mit jeweils mindestens 5 Meßpunkten weiterverfolgt. Das Verfahren wurde als geeignet befunden, schwere hepatozelluläre Schäden im Verlauf der Kaltischämie zu erfassen.
    Notes: Abstract In 22 human donor livers the measurement of the non-invasive bioelectrical impedance was performed prospectively to evaluate the degree of tissue damage sustained during cold ischemia. The results of the measurement were correlated with liver function, the method of organ preservation and the period of ischemia. The impedance was measured in vivo as 620 ohm (at 192 Hz), the phase angle as −7.4° (at 5 kHz). The results were compared with the data obtained from 72 patients who underwent elective laparotomies. The 22 donor livers were studied further during ischemia. The method was found to be a reliable way of detecting severe damage to the hepatocytes during the cold ischemia.
    Type of Medium: Electronic Resource
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