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| 1 | Biliary complications in liver transplantation: Impact of anastomotic technique and ischemic time on short- and long-term outcome显示文摘AIM: To elucidate the impact of various donor recipient and transplant factors on the development of biliary complications after liver transplantation.METHODS: We retrospectively reviewed 200 patients of our newly established liver transplantation(LT) program, who received full size liver graft. Biliary reconstruction was performed by side-to-side(SS), end-to-end(EE) anastomosis or hepeaticojejunostomy(HJ). Biliary complications(BC), anastomotic stenosis, bile leak, papillary stenosis, biliary drain complication, ischemic type biliary lesion(ITBL) were evaluated by studying patient records, corresponding radiologic imaging and reports of interventional procedures [e.g., endoscopic retrograde cholangiopancreatography(ERCP)]. Laboratory results included alanine aminotransferase(ALT), gammaglutamyltransferase and direct/indirect bilirubin with focus on the first and fifth postoperative day, six weeks after LT. The routinely employed external bile drain was examined by a routine cholangiography on the fifth postoperative day and six weeks after transplantation as a standard procedure, but also whenever clinically indicated. If necessary, interventional(e.g., ERCP) or surgical therapy was performed. In case of biliary complication, patients were selected, assigned to different complication-groups and subsequently reviewed in detail. To evaluate the patients outcome, we focussed on appearance of postoperative/post-interventional cholangitis, need for rehospitalisation, retransplantation, ITBL or death caused by BC.RESULTS: A total of 200 patients [age: 56(19-72), alcoholic cirrhosis: n = 64(32%), hepatocellular carcinoma: n = 40(20%), acute liver failure: n = 23(11.5%), cryptogenic cirrhosis: n = 22(11%), hepatitis B virus /hepatitis C virus cirrhosis: n = 13(6.5%), primary sclerosing cholangitis: n = 13(6.5%), others: n = 25(12.5%) were included. The median follow-up was 27 mo until June 2015. The overall biliary complication rate was 37.5%(n = 75) with anastomotic strictures(AS): n = 38(19%), bile leak(BL): n = 12(6%), biliary drain complication: n = 12(6%); papillary stenosis(PS): n = 7(3.5%), ITBL: n = 6(3%). Clinically relevant were only 19%(n = 38). We established a comprehensive classification for AS with four grades according to clinical relevance. The reconstruction techniques [SS: n = 164, EE: n = 18, HJ: n = 18] showed no significant impact on the development of BCs in general(all n < 0.05), whereas in the HJ group significantly less AS were found(P = 0.031). The length of donor intensive care unit stay over 6 d had a significant influence on BC development(P = 0.007, HR = 2.85; 95%CI: 1.33-6.08) in the binary logistic regression model, whereas other reviewed variables had not [warm ischemic time > 45 min(P = 0.543), cold ischemic time > 10 h(P = 0.114), ALT init > 1500 U/L(P = 0.631), bilirubin init > 5 mg/d L(P = 0.595), donor age > 65(P = 0.244), donor sex(P = 0.068), rescue organ(P = 0.971)]. 13%(n = 10) of BCs had no therapeutic consequences, 36%(n = 27) resulted in repeated lab control, 40%(n = 30) received ERCP and 11%(n = 8) surgical therapy. Fifteen(7.5%) patients developed cholangitis [AS(n = 6), ITBL(n = 5), PS(n = 3), biliary lesion BL(n = 1)]. One patient developed ITBL twelve months after LT and subsequently needed retransplantation. Rehospitalisation rate was 10.5 %(n = 21) [AS(n = 11), ITBL(n = 5), PS(n = 3), BL(n = 1)] with intervention or reinterventional therapy as main reasons. Retransplantation was performed in 5(2.5%) patients [ITBL(n = 1), acute liver injury(ALI) by organ rejection(n = 3), ALI by occlusion of hepatic artery(n = 1)]. In total 21(10.5%) patients died within the follow-up period. Out of these, one patient with AS developed severe fatal chologenic sepsis after ERCP.CONCLUSION: In our data biliary reconstruction technique and ischemic times seem to have little impact on the development of BCs. | Stefan Kienlein Wenzel Schoening Anne Andert Daniela Kroy Ulf Peter Neumann Maximilian Schmeding | 2015 | World Journal of Transplantation2015，5，4： | 14 |
| 2 | Extended surgical resection for xanthogranulomatous cholecystitis mimicking advanced gallbladder carcinoma: A case report and review of literature显示文摘Xanthogranulomatous 胆汁(XGC ) 是胆囊的破坏煽动性的疾病,很少包含邻近的机关并且模仿国王先进胆囊癌。诊断在病理学的检查以后仅仅通常是可能的。46 42 岁的女人被指我们包含肝核,正确的肝脑叶,恰好结肠的弯曲,和十二指肠的怀疑的胆囊癌症的中心。刷细胞学获得了由内视镜后退胆管造影术(ERC ) 出现了高级发育异常。病人经历了团的在团体切除术,由正确叶切除术,正确的半结肠切除术,和部分十二指肠的切除术组成。出人意料地揭示的病理学的检查一 XGC.Only,为有邻近的机关的直接参与的 XGC 的扩大外科的切除术的六个案例到目前为止被报导了。在这些情况中,与癌给 XGC 的可能的共存,恶意不能被排除,甚至在细胞学和 intraoperative 冰冻切片调查以后。在结论,由于源于在另外的方面上包围机关的高度好攻击的煽动性的侵略的一个方面和可能的复杂并发症上的胆囊癌的差的预后,它似乎这些案例应该被当作恶性瘤直到不那样证明。临床医生们应该包括 XGC 在之中可能微分在肝核群众诊断。 | Antonino Spinelli Guido Schumacher Andreas Pascher Enrique Lopez-Hanninen Hussain Al-Abadi Christoph Benckert Igor M Sauer Johann Pratschke Ulf P Neumann Sven Jonas Jan M Langrehr Peter Neuhaus | 2006 | World Journal of Gastroenterology2006，12，14： | 13 |
| 3 | Grade of donor liver microvesicular steatosis does not affect the postoperative outcome after liver transplantation显示文摘BACKGROUND:The potential effect of graft steatosis on the postoperative liver function is discussed controversially. The present study aimed to evaluate the effect of the donor liver microvesicular steatosis on the postoperative outcome after liver transplantation.METHODS:Ninety-four patients undergoing liver transplantation at the University Hospital Aachen were included in this study. The patient cohort was divided into three groups according to the grade of microvesicular steatosis(MiS):MiS <30%(n=27), MiS 30%-60%(n=41) and MiS >60%(n=26).The outcomes after liver transplantation were evaluated, including the 30-day and 1-year patient and graft survival rates and the incidences of early allograft dysfunction(EAD) and primary nonfunction(PNF). RESULTS:The incidences of EAD and PNF did not differ significantly between the groups. We observed 5 cases of PNF,one occurred in the MiS <30% group and 4 in the MiS 30%-60% group. The 30-day and 1-year graft survivals did not differ significantly between groups. The 30-day patient survival rates were 100% in all groups. The 1-year patient survival rates were 94.4% in the MiS <30% group, 87.9% in the MiS 30%-60% group and 90.9% in the MiS >60% group.CONCLUSION:Microvesicular steatosis of donor livers has no negative effect on the postoperative outcome after liver transplantation. | Anne Andert Tom Florian Ulmer Wenzel Schoning Daniela Kroy Marc Hein Patrick Hamid Alizai Christoph Heidenhain Ulf Neumann Maximilian Schmeding | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，6： | 7 |
| 4 | Impact of body composition on survival and morbidity after liver resection in hepatocellular carcinoma patients显示文摘Background: Hepatocellular carcinoma is the most common innate liver tumor. Due to improved surgical techniques, even extended resections are feasible, and more patients can be treated with curative intent. As the liver is the central metabolic organ, preoperative metabolic assessment is crucial for risk stratification. Sarcopenia, obesity and sarcopenic obesity characterize body composition and metabolic status. Here we present the impact of body composition on survival after liver resection in patients with hepatocellular carcinoma. Methods: A retrospective database analysis of 70 patients who were assigned for liver resection due to hepatocellular carcinoma was conducted. For assessment of sarcopenia and obesity, skeletal muscle surface area was measured at lumbar vertebra 3 level(L3) in preoperative four-phase contrast enhanced abdominal CT scans, and L3 muscle index and body fat percentage were calculated. Results: Univariate analysis comparing the survival curves using the score test demonstrated superior postoperative overall survival for sarcopenic( P = 0.035) and sarcopenic obese( P = 0.048) patients as well as a trend favoring obese( P = 0.130) subjects. Whereas multivariate analysis could not identify significant difference in postoperative survival regarding sarcopenia, obesity or sarcopenic obesity. Only large tumor size, multifocal disease and male gender were risk factors for long-term survival. Conclusions: Sarcopenia, obesity and sarcopenic obesity are indeed no risk factors for poor postoperative survival in this study. Our data do not support the evaluation of sarcopenia, obesity and sarcopenic obesity before liver resection in hepatocellular carcinoma patients. | Andreas Kroh Diane Uschner Toine Lodewick Roman M Eickhoff Wenzel Sch?ning Florian T Ulmer Ulf P Neumann Marcel Binneb?sel | 2019 | Hepatobiliary & Pancreatic Diseases International2019，18，1： | 5 |
| 5 | Comparative study of the effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats显示文摘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 7.RESULTS: 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 H_2O and PHS: 7.50±0.93,8.88 ±2.42, 5.75±1.04 cm H_2O) was lower compared to the control group(PHC: 8.63±2.06, 10.50±2.45, 6.50±2.67 cmH_2O). 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 significant.CONCLUSIONS: 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 liver regeneration. | Tom Florian Ulmer Anne Weiland Georg Lurje Christian Klink Anne Andert Hamid Alizai Christoph Heidenhain Ulf Neumann | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，5： | 3 |
| 6 | Simultaneous versus staged liver resection of synchronous liver metastases from colorectal cancer显示文摘 | Armin Thelen Sven Jonas Christoph Benckert Antonino Spinelli Enrico Lopez-H?nninen Birgit Rudolph Ulf Neumann Peter Neuhaus | 2007 | International Journal of Colorectal Disease2007，，10： | 2 |
| 7 | Outcome after liver re‐transplantation in patients with recurrent chronic hepatitis C显示文摘 | Marcus Bahra Ulf Peter Neumann Dietmar Jacob Thomas Berg Ruth Neuhaus Jan Michael Langrehr Peter Neuhaus | 2007 | Transplant International2007，，9： | 1 |
| 8 | Biomechanical analyses of prosthetic mesh repair in a hiatal hernia model显示文摘 | Patrick Hamid Alizai Sofie Schmid Jens Otto Christian Daniel Klink Anjali Roeth Jochen Nolting Ulf Peter Neumann Uwe Klinge | 2014 | J. Biomed. Mater. Res2014，，7： | 1 |
| 9 | Simultaneous splenectomy increases risk for opportunistic pneumonia in patients after liver transplantation显示文摘 | Ulf P. Neumann Jan M. Langrehr Udo Kaisers Martina Lang Volker Schmitz Peter Neuhaus | 2002 | Transplant International2002，，5： | 1 |
| 10 | Outcomes of extended versus limited indications for patients undergoing a liver resection for colorectal cancer liver metastases显示文摘 | Ronald M. Dam Toine M. Lodewick Maartje A.J. Broek Mechteld C. Jong Jan Willem Greve Rob L.H. Jansen Marc H.A. Bemelmans Ulf P. Neumann Steven W.M. Olde Damink Cornelis H.C. Dejong | 2014 | HPB2014，，6： | 1 |
| 11 | SIGNIFICANCE OF A T-LYMPHOCYTOTOXIC CROSSMATCH IN LIVER AND COMBINED LIVER-KIDNEY TRANSPLANTATION显示文摘 | Ulf P. Neumann Martina Lang Anja Moldenhauer Jan M. Langrehr Matthias Glanemann Andreas Kahl Ullrich Frei Wolf O. Bechstein Peter Neuhaus | 2001 | Transplantation2001，，8： | 1 |
| 12 | De novo malignancies after liver transplantation using tacrolimus - based protocols or cyclosporine- based quadruple immunosuppression with an interleukin - 2 receptor antibody or antithymocyte globulin 显示文摘 | Sven Jonas Nada Rayes Ulf Neumann | 1997 | Cancer1997，80，6： | 1 |
| 13 | Treatment of Patients with Recurrent Hepatitis C after Liver Transplantation with Peginterferon Alfa-2B Plus Ribavirin显示文摘 | Ulf Neumann Gero Puhl Marcus Bahra Thomas Berg Jan Michael Langrehr Ruth Neuhaus Peter Neuhaus | 2006 | Transplantation2006，，1： | 1 |
| 14 | Antiviral Treatment of Patients with Recurrent Hepatitis C After Liver Transplantation with Pegylated Interferon显示文摘 | Sven C. Schmidt Marcus Bahra Sandra Bayraktar Thomas Berg Maximilian Schmeding Johann Pratschke Peter Neuhaus Ulf Neumann | 2010 | Digestive Diseases and Sciences2010，，7： | 1 |
| 15 | Incidence of and risk factors for ischemic‐type biliary lesions following orthotopic liver transplantation显示文摘 | Christoph Heidenhain Johann Pratschke Gero Puhl Ulf Neumann Andreas Pascher Winfried Veltzke‐Schlieker Peter Neuhaus | 2009 | Transplant International2009，，1： | 1 |
| 16 | Adiponectin isoforms: a potential therapeutic target in rheumatoid arthritis?显示文摘 | Klaus W Frommer Andreas Sch?ffler Christa Büchler Jürgen Steinmeyer Markus Rickert Stefan Rehart Fabia Brentano Steffen Gay Ulf Müller-Ladner Elena Neumann | 2012 | Annals of the Rheumatic Diseases2012，，10： | 1 |
| 17 | Mycophenolate Mofetil Monotherapy in Liver Transplantation: 5-Year Follow-Up of a Prospective Randomized Trial显示文摘 | Maximilian Schmeding Anja Kiessling Ruth Neuhaus Christoph Heidenhain Marcus Bahra Peter Neuhaus Ulf P. Neumann | 2011 | Transplantation2011，，8： | 1 |
| 18 | The effect of thermotherapy using magnetic nanoparticles on rat malignant glioma显示文摘 | Andreas Jordan Regina Scholz Klaus Maier-Hauff Frank K.H. Landeghem Norbert Waldoefner Ulf Teichgraeber Jens Pinkernelle Harald Bruhn Fabian Neumann Burghard Thiesen Andreas Deimling Roland Felix | 2006 | Journal of Neuro - Oncology2006，，1： | 1 |
| 19 | Role of IL28B Polymorphism in the Development of Hepatitis C Virus-Induced Hepatocellular Carcinoma, Graft Fibrosis, and Posttransplant Antiviral Therapy显示文摘 | Dennis Eurich Sabine Boas-Knoop Marcus Bahra Ruth Neuhaus Rajan Somasundaram Peter Neuhaus Ulf Neumann Daniel Seehofer | 2012 | Transplantation2012，，6： | 1 |
| 20 | Fibrosis progression after liver transplantation in patients with recurrent hepatitis C显示文摘 | Ulf P. Neumann Thomas Berg Marcus Bahra Daniel Seehofer Jan M. Langrehr Ruth Neuhaus Cornelia Radke Peter Neuhaus | 2004 | Journal of Hepatology2004，，5： | 1 |
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