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  • 1
    Electronic Resource
    Electronic Resource
    Indikationsstellung zur Lebertransplantation bei schwerer Knollenblätterpilzvergiftung (1996)
    Springer
    Der Chirurg 67 (1996), S. 996-1001 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Mushroom poisoning ; Liver transplantation ; Fulminant hepatic failure.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Der Verlauf von 12 Patienten mit Knollenblätterpilzvergiftung wurde retrospektiv analysiert, um prognostische Kriterien für die Indikationsstellung zur Lebertransplantation herauszuarbeiten. Acht Patienten erholten sich unter konservativer Therapie, bei 3 Patienten war eine Lebertransplantation erforderlich; ein Patient starb bei Vorliegen schwerer Begleiterkrankungen unter konservativer Therapie. Die transplantierten Patienten wiesen initial einen Quick- und Faktor-V-Wert unter 10 % auf. Die Höhe der Transaminasen, des Serumbilirubins, des Serumkreatinins, eine Verlängerung der PTT sowie eine Azotämie hatten keinen sicheren prognostischen Wert. Für die Indikationsstellung zur Transplantation war der initiale Quick- und Faktor-V-Wert und deren inadäquater Anstieg unter Substitution entscheidend. Die Ausbildung einer Encephalopathie sowie ein progredientes Nierenversagen stellen zusätzliche prognostisch schlechte Parameter dar.
    Abstract: Schlüsselwörter: Knollenblätterpilzvergiftung – Lebertransplantation – fulminantes Leberversagen.
    Notes: Summary. The clinical course of 12 patients with mushroom poisoning was evaluated in order to define the parameters considered to be relevant to the indication for liver transplantation. Eight patients recovered under conservative therapy; one patient died due to pre-existing, concomitant cardiopulmonary disease. In three patients transplantations had to be performed because of severe liver failure. On admission, the transplanted patients had a decreased Quick's test score and factor V value (〈 10 %). The peak of liver enzymes, serum bilirubin, serum creatinine, partial thromboplastin time and azotemia were not of any prognostic value. Main indications for liver transplantation were a very low initial Quick's test score and factor V value (both 〈 10 %) and their inadequate response under substitution therapy. The development of encephalopathy and renal failure were further parameters indicating poor prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00002517
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Ciclosporin metabolite pattern in blood and urine of liver graft recipients (1991)
    Springer
    European journal of clinical pharmacology 41 (1991), S. 291-296 
    Details
    ISSN: 1432-1041
    Keywords: Ciclosporin ; Liver transplantation ; metabolites ; cholestasis ; rejection ; M19 ; M1A
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The pattern of metabolites of ciclosporin in blood and 24 h-urine of 58 liver graft recipients was routinely monitored by HPLC from transplantation until discharge from hospital. Liver function and ciclosporin metabolite pattern in patients with an uncomplicated clinical course and in those with cholestasis or acute rejection were compared. During cholestasis M19 and M1A, and during acute rejection M19, in blood were significantly elevated compared to the control group. Blood M19 was significantly correlated with bilirubin concentration and γ-glutamyl transferase activity in serum, and M1A with the serum bilirubin concentration. Analysis of the metabolite pattern over the observation period showed higher concentrations of M19 and M1A in blood from patients with cholestasis and acute rejection than in the control group; concentrations were lower in the rejection group than in the cholestasis group. The metabolite pattern in 24 h-urine showed similar alterations in ciclosporin metabolite pattern to those in blood. Cholestasis and rejection shift the ciclosporin metabolite pattern in blood and urine to higher concentrations of M19 and M1A, whereas the concentrations of other metabolites and ciclosporin were not significantly affected.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314954
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Septic shock after liver transplantation for Caroli's disease: clinical improvement after treatment with C1-esterase inhibitor (1999)
    Springer
    Intensive care medicine 25 (1999), S. 1017-1020 
    Details
    ISSN: 1432-1238
    Keywords: Key words C1-esterase inhibitor ; Complement system ; Sepsis ; Liver transplantation ; Caroli's disease ; Colloid osmotic pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The extent of complement and contact activation is related to outcome in sepsis. A low functional index of their main blocker C1-esterase inhibitor (C1-INH) is considered as a relative deficiency of C1-INH and might contribute to the development of fatal complications in the intensive care unit. The first results of therapeutic intervention with C1-INH concentrate in septic shock are promising. We report on our experience of C1-INH concentrate administration in a young woman with Caroli's disease as ultimate rescue therapy for septic shock with capillary leakage syndrome after combined liver and kidney transplantation. No focus of infection was detectable and thus surgical intervention was not indicated. Antibiotic therapy at that time included vancomycin, tobramycin, meropenem and fluconazol. Hemodynamic stabilization occurred within hours after administration of C1-INH concentrate. Simultaneously a reduction in vasopressor medication was possible and negative fluid balance was achieved.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051000
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Indikationsstellung zur Lebertransplantation bei schwerer Knollenblätterpilzvergiftung (1996)
    Springer
    Der Chirurg 67 (1996), S. 984-988 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Mushroom poisoning ; Liver transplantation ; Fulminant hepatic failure.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Der Verlauf von 12 Patienten mit Knollenblätterpilzvergiftung wurde retrospektiv analysiert, um prognostische Kriterien für die Indikationsstellung zur Lebertransplantation herauszuarbeiten. Acht Patienten erholten sich unter konservativer Therapie, bei 3 Patienten war eine Lebertransplantation erforderlich; ein Patient starb bei Vorliegen schwerer Begleiterkrankungen unter konservativer Therapie. Die transplantierten Patienten wiesen initial einen Quick- und Faktor-V-Wert unter 10 % auf. Die Höhe der Transaminasen, des Serumbilirubins, des Serumkreatinins, eine Verlängerung der PTT sowie eine Azotämie hatten keinen sicheren prognostischen Wert. Für die Indikationsstellung zur Transplantation war der initiale Quick- und Faktor-V-Wert und deren inadäquater Anstieg unter Substitution entscheidend. Die Ausbildung einer Encephalopathie sowie ein progredientes Nierenversagen stellen zusätzliche prognostisch schlechte Parameter dar.
    Abstract: Schlüsselwörter: Knollenblätterpilzvergiftung – Lebertransplantation – fulminantes Leberversagen.
    Notes: Summary. The clinical course of 12 patients with mushroom poisoning was evaluated in order to define the parameters considered to be relevant to the indication for liver transplantation. Eight patients recovered under conservative therapy; one patient died due to pre-existing, concomitant cardiopulmonary disease. In three patients transplantations had to be performed because of severe liver failure. On admission, the transplanted patients had a decreased Quick's test score and factor V value (〈 10 %). The peak of liver enzymes, serum bilirubin, serum creatinine, partial thromboplastin time and azotemia were not of any prognostic value. Main indications for liver transplantation were a very low initial Quick's test score and factor V value (both 〈 10 %) and their inadequate response under substitution therapy. The development of encephalopathy and renal failure were further parameters indicating poor prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00002516
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 5
    Electronic Resource
    Electronic Resource
    Therapie der persistierenden Oesophagusvaricenblutung mittels intrahepatischem portosystemischem Stent-Shunt und kurzfristig folgender Lebertransplantation (1997)
    Springer
    Der Chirurg 68 (1997), S. 385-388 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Shunt ; portosystemic ; Intrahepatic portosystemic stent shunt ; Liver transplantation ; Esophageal varices ; bleeding ; Portal hypertension. ; Schlüsselwörter: Shunt ; portosystemischer ; TIPSS ; Lebertransplantation ; Oesophagusvaricenblutung ; portale Hypertension.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Bei einer 41 jährigen Patientin mit fortgeschrittener Lebercirrhose bei Autoimmunhepatitis wurde aufgrund einer therapierefraktären Oesophagusvaricenblutung notfallmäßig ein transjugulärer portosystemischer Stent-Shunt (TIPSS) implantiert. Aufgrund der stark eingeschränkten Leberfunktion wurde eine dringende Indikation zur Lebertransplantation gestellt, die am nächsten Tag erfolgte. Während der Transplantation kam es klinisch inapparent zur Dislokation einer der kurz zuvor implantierten Metall-Stents in die Lungenarterie. Der postoperative Verlauf war unauffällig, der dislozierte Stent wurde in situ belassen. 18 Monate nach Lebertransplantation ist die Patientin beschwerdefrei mit normaler Leberfunktion und ohne pulmonale Probleme.
    Notes: Summary. A 41-year-old patient with liver cirrhosis due to autoimmune hepatitis received an emergency transjugular portosystemic stent shunt for uncontrolled acute variceal hemorrhage. Because of markedly impaired liver function, liver transplantation was considered to be indicated and was performed on the following day. Intraoperatively, one of the intrahepatic metal stents migrated unnoticed into the pulmonary artery. The postoperative course was uncomplicated and the displaced stent was left in situ. Eighteen months after the transplantation the patient is well with normal liver function and no pulmonary problems.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050202
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    Paper (German National Licenses)
    Fulltext
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