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  • 1
    ISSN: 1432-1076
    Keywords: Liver transplantation ; Liver function tests ; Prognostic tests
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pre-operative risk of paediatric liver transplantation candidates (n=41) was assessed in a prospective study by means of clinical symptoms, conventional static and liver blood flow dependent dynamic liver function tests. Nine patients died during the 365-day waiting period. The data were subjected as covariates to a survival analysis in the Cox proportional hazards model. There was a significant relationsship between the results of mono-ethylglycinexylidide (MEGX) formation and ICG test and the 365-day survival rate. In the stepwise analysis, none of the remaining parameters improved the predictive ability when added to the dynamic liver function test results. The assessment of post-transplantation liver function was studied in 27 patients during the first 28 postoperative-day period. In addition, liver function was studied in a cross-sectional study 1–7 years after successful liver transplantation in children with complete or partial rehabilitation. In the early postoperative period severe organ damage was indicated by both static and dynamic liver function tests. In the later course after transplantation no deterioration of liver function measured with MEGX formation was to be observed. These findings demonstrate the usefulness of dynamic liver function tests in the pre- and post-transplant assessment of liver function.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Haemoperfusion ; Carbromal ; Diazepam ; Phenobarbital ; Hämoperfusion ; Carbromal ; Diazepam ; Phenobarbital
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In der vorliegenden Arbeit werden die Adsorptionseigenschaften von 6 verschiedenen Materialien, die bei der Hämoperfusion eingesetzt werden in vitro geprüft: Amberlite XAD-2 und XAD-4, Haemocol, Collodium verkapselte Aktivkohle, Collodium verkapselte und Albumin beschichtete Aktivkohle und Aktivkohle-Hohlfaser. Carbromal wird am schnellsten eliminiert von Amberlite XAD-2 und XAD-4, ebenso Diazepam. Beim Vergleich der verschiedenen Kohlepräparate werden Carbromal und Diazepam am schnellsten von Haemocol aus der Lösung entfernt, Phenobarbital von Aktivkohle-Hohlfaser, wenn man eine 5-stündige Perfusion zu Grunde legt. Die gerinnungsphysiologischen und klinisch-chemischen Untersuchungen mit Hilfe von heparinisiertem Frischblut lassen schwerwiegende Nebenwirkungen erkennen. Die Abnahme der Thrombozyten ist am ausgeprägtesten bei Amberlite XAD-2 und XAD-4, sie ist aber auch bei den Kohlepräparationen nachweisbar: Nach 5stündiger Hämoperfusion ist ihre Zahl auf bis zu 10% des Ausgangswertes abgefallen. Die Hämolyse ist besonders stark bei Amberlite XAD-2 und XAD-4, sowie Haemocol. Die je nach Giftstoff unterschiedlich große Adsorption der geprüften Materialien und ihre verschieden stark ausgeprägten Nebenwirkungen erfordern nach unseren Ergebnissen einen der individuellen Situation des Patienten angepaßten Einsatz.
    Notes: Summary The properties of six adsorbents for Haemoperfusion were investigated in vitro: Amberlite XAD-2; Amberlite XAD-4; Haemocol; collodion coated charcoal; albumine-collodion encapsulated charcoal and activated carbon fibers. Carbromal and diazepam are most quickly removed from aqueous solutions by Amberlite XAD-2 and XAD-4. Of the charcoal containing materials, Haemocol eliminates most rapidly carbromal and diazepam; while activated carbon fibers remove phenobarbital faster. When heparinized blood is perfused, a remarkable reduction in platelet count is observed. The drop is most pronounced with Amberlite XAD-2 and XAD-4, but even when using charcoal preparations the platelet depletion can reach 10% of the original number over 5 hours. Haemolysis is most pronounced with Amberlite XAD-2, XAD-4 and Haemocol. As the efficiency of the adsorbents towards the various drugs differ and as their adverse effects also vary, the decision for a particular material will have to be made according to the individual case.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-2277
    Keywords: Liver transplantation ; graft prognosis test — Prognosis ; liver transplantation ; ketone body ratio — Arterial ketone body ratio ; prognosis liver graft
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate the ability of arterial ketone body ratio (AKBR; acetoacetate/3-hydroxybutyrate) to predict graft prognosis after liver transplantation, the diagnostic value as a predictive index was compared between AKBR and conventional liver function tests using receiver operating characteristic (ROC) analysis. The ROC curves were determined for AKBR, GOT, GPT, total bilirubin, serum lactate level, and prothrombin time, all of which were measured on the 1st and 2nd postoperative days in 88 cases of liver transplantation. Comparisons of the areas under the ROC curves between AKBR and other tests revealed the significant superiority of AKBR to other tests in predicting graft death within 1 month after transplantation. The present study suggests that AKBR can be used as an accurate index to predict graft prognosis after liver transplantation.
    Type of Medium: Electronic Resource
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