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Influence of skeletal muscle mass on graft regeneration after living-donor liver transplantation

Hepatobiliary Surgery and Nutrition 2021年第4期10卷 564-566页

作者： Deniz Uluk Johann Pratschke georg lurje Department of Surgery Campus CharitéMitte|Campus Virchow-KlinikumCharité-Universitätsmedizin BerlinBerlinGermany

Body composition(BC)is defined as the relative proportion of fat,water,protein,and mineral components in the body and varies greatly among *** skeletal muscle depletion is frequently seen in severely ill patients,sarcopenia,defined as a pathological reduction of skeletal muscle mass(SMM)and strength,is one of the most significant features of the metabolic imbalance related to end stage liver disease(ESLD).

关键词： skeletal liver donor

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Comparative study of the effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats

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Hepatobiliary & Pancreatic Diseases International 2017年第5期16卷 506-511页

作者： Tom Florian Ulmer Anne Weiland georg lurje Christian Klink Anne Andert Hamid Alizai Christoph Heidenhain Ulf Neumann Department of General Visceral and Transplantation Surgery RWTH Aachen University Hospital Aachen Germany Department of Urology Helios Hospital Berlin-Buch Germany

BACKGROUND: Post-hepatectomy liver failure as a result of insufficient liver remnant is a feared complication in liver surgery. Efforts have been made to find new strategies to support liver regeneration. The aim of this study was to investigate the effects of terlipressin versus splenectomy on postoperative liver function and liver regeneration in rats undergoing 70%partial hepatectomy. METHODS: Seventy-two male Wistar rats were randomly assigned into three groups(n=24 in each group): 70% partial hepatectomy as control(PHC), 70% partial hepatectomy with splenectomy(PHS) or 70% partial hepatectomy with a micropump for terlipressin administration(PHT). Eight rats in each group were sacrificed on postoperative day(POD) 1,3 and 7. To assess liver regeneration, immunohistochemical analysis of liver tissue using bromodeoxyuridine(BrdU) and Ki-67 labeling was performed. Portal venous pressure, serum concentrations of creatinine, urea, albumin, bilirubin and prothrombin time as well as liver-, body-weight and their ratio were determined on POD 1, 3 and ***: The liver-, body-weight and their ratio were not statistically different among the groups. On POD 1, 3 and 7 portal venous pressure in the intervention groups(PHT:8.13 ±1.55, 10.38±1.30, 6.25±0.89 cm H2O and PHS: 7.50±0.93,8.88 ±2.42, 5.75±1.04 cm H2O) was lower compared to the control group(PHC: 8.63±2.06, 10.50±2.45, 6.50±2.67 cmH2O). Hepatocyte proliferation in the intervention groups was delayed, especially after splenectomy on POD 1(Brd U: PHS vs PHC, 20.85% ±13.05% vs 28.11%±10.10%; Ki-67, 20.14%±14.10% vs 23.96% ±11.69%). However, none of the differences were statistically ***: Neither the administration of terlipressin nor splenectomy improved liver regeneration after 70% partial hepatectomy in rats. Further studies assessing the regulation of portal venous pressure as well as extended hepatectomy animal models and liver function tests will help to further investigate mechanisms of live

关键词： liver regeneration liver failure terlipressin splenectomy hepatectomy

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Loco-regional hepatocellular carcinoma treatment services as a bridge to liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2019年第3期18卷 228-236页

作者： Sophia Schmitz georg lurje Florian Ulmer Anne Andert Philipp Bruners Maximilian Schulze-Hagen Ulf Neumann Wenzel Schoening Department of General- Visceral- and Transplantation Surgery University Hospital of RWTH Aachen Aachen Germany Department of Diagnostic and Interventional Radiology University Hospital of RWTH Aachen Aachen Germany Department of Surgery Maastricht University Medical Center (MUMC) Maastricht Netherlands Department of Surgery Charité– University Medicine at Berlin Germany

Background: Liver transplantation remains the main curative treatment option for hepatocellular carcinoma(HCC) patients. In the Eurotransplant area Milan criteria are used to assign priority extra points(exceptional MELD, ex MELD) for patients on the waiting list. To prevent patients from tumor progression, loco-regional(neoadjuvant) treatment(LRT) is used. For patients unlikely to timely receive an organ via primary allocation,“extended critera donor(ECD) organs” are used. The present study aimed to investigate the survival after LT with a strategy of minimizing waiting list dropouts by using LRT for bridging and transplanting ECD organs if possible and necessary. Methods: Between October 2010 and May 2015, 50 liver transplants for HCC were included in this retrospective study. Of those, 42(84%) met the Milan criteria according to the preoperative radiological examination. Forty-one patients(82%) received LRT. The waiting time was analyzed according to LRT. Kaplan-Meier curves with log-rank statistics were used for survival analyses. Results: One-and five-year overall survival within Milan criteria was 94.3% and 83.7% compared with 91.7% and 67.9% beyond Milan criteria, though statistical significance was not reached( P = 0.487). LRT had no impact on overall survival( P = 0.629). Median waiting time was shorter if no LRT was performed(4.6 months vs. 1.5 months, P = 0.006) and there were no cases of waiting list dropouts. Using ECD organs had no impact on overall survival( P = 0.663). Conclusions: Patients with an expected waiting time to transplantation of > 6 months could be successfully treated with LRT as a bridge to transplant. Overall and disease-free survival for patients within and beyond Milan criteria was comparable and the use of ECD organs in this cohort of HCC patients proved to be a safe option.

关键词： Hepatocellular carcinoma Liver transplantation Therapeutic embolization Liver neoplasms Organ transplantation

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