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  • Wiley  (3)
  • Herden, Uta  (3)
  • 2010-2014  (3)
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  • Wiley  (3)
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  • 2010-2014  (3)
Year
  • 1
    Online Resource
    Online Resource
    Outcome of liver re‐transplantation in children—Impact and special analysis of early re‐transplantation
    Wiley ; 2014
    In:  Pediatric Transplantation Vol. 18, No. 4 ( 2014-06), p. 377-384
    Details
    In: Pediatric Transplantation, Wiley, Vol. 18, No. 4 ( 2014-06), p. 377-384
    Abstract: In case of graft failure, re‐ LTX is the only life‐saving option but it has been associated with inferior results. This study analyzes the outcome following pediatric re‐ LTX with a main focus on the timely relation between initial transplant and re‐ LTX . All pediatric LTX at our institution between 2000 and 2010 divided into patients with primary LTX and patients undergoing re‐ LTX early (≤30 days) or late ( 〉 30 days) after previous LTX were analyzed. Two hundred and ninety‐eight primary LTX (79%), 33 early (9%), and 46 late (12%) re‐ LTX were performed. Patient/graft survival was significantly worse for children undergoing early re‐ LTX compared to primary LTX and late re‐ LTX (p = 0.024/0.001 and p = 0.015/0.03). One‐/five‐yr graft survival rates were 66%/49% for early re‐ LTX compared to 86%/76% for late re‐ LTX and 90%/74% for primary LTX . The inferior results in children undergoing early re‐ LTX were due to events occurring in the first six months with similar survival thereafter. No difference in outcome was evident after adjustment of the groups for high‐urgency status. Outcome was excellent for primary LTX and late re‐ LTX , supporting late re‐ LTX in children. Early re‐ LTX takes an elevated risk of early graft loss and patient death; however, beyond the early postoperative period, the outcome was comparable.
    Type of Medium: Online Resource
    ISSN: 1397-3142 , 1399-3046
    URL: Issue
    URL: Article
    DOI: 10.1111/petr.2014.18.issue-4
    DOI: 10.1111/petr.12264
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2008614-3
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Developments in pediatric liver transplantation since implementation of the new allocation rules in Eurotransplant
    Wiley ; 2014
    In:  Clinical Transplantation Vol. 28, No. 9 ( 2014-09), p. 1061-1068
    Details
    In: Clinical Transplantation, Wiley, Vol. 28, No. 9 ( 2014-09), p. 1061-1068
    Abstract: Liver allocation in the Eurotransplant ( ET ) region has changed from a waiting time to an urgency‐based system using the model of end‐stage liver disease ( MELD ) score in 2006. To allow timely transplantation, pediatric recipients are allocated by an assigned pediatric MELD independent of severity of illness. Consequences for children listed at our center were evaluated by retrospective analysis of all primary pediatric liver transplantation ( LTX ) from deceased donors between 2002 and 2010 (110 LTX before/50 LTX after new allocation). Of 50 children transplanted in the MELD era, 17 (34%) underwent LTX with a high‐urgent status that was real in five patients (median lab MELD 22, waiting time five d) and assigned in 12 patients (lab MELD 7, waiting time 35 d). Thirty‐three children received a liver by their assigned pediatric MELD (lab MELD 15, waiting time 255 d). Waiting time in the two periods was similar, whereas the wait‐list mortality decreased (from about four children/yr to about one child/yr). One‐ and three‐yr patient survival showed no significant difference (94.5/97.7%; p   =   0.385) as did one‐ and three‐yr graft survival (80.7/75.2%; and 86.5/82%; p   =   0.436 before/after). Introduction of a MELD ‐based allocation system in ET with assignment of a granted score for pediatric recipients has led to a clear priorization of children resulting in a low wait‐list mortality and good clinical outcome.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    URL: Article
    DOI: 10.1111/ctr.2014.28.issue-9
    DOI: 10.1111/ctr.12420
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2739458-X
    detail.hit.zdb_id: 2004801-4
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Successful outcome of severe Amanita phalloides poisoning in children
    Wiley ; 2013
    In:  Pediatric Transplantation Vol. 17, No. 6 ( 2013-09), p. 550-555
    Details
    In: Pediatric Transplantation, Wiley, Vol. 17, No. 6 ( 2013-09), p. 550-555
    Abstract: Amanita phalloides intoxication can lead to FHF with high mortality, especially in children. There is still ongoing discussion about the optimal treatment and decision criteria for emergency liver transplantation ( LT x). Here, we summarize our experience with outcomes in five children. Five children with severe A. phalloides intoxication were treated at our tertiary center from 1995 to 2010 and studied retrospectively with respect to clinical and laboratory aspects that might help to decide between LT x or conservative therapy only. The findings are discussed with regard to recommended treatment and transplantation criteria for adults. All patients survived, of whom two of five received emergency LT x. Three patients survived with conservative treatment consisting of intravenous silibinin, NAC, detoxification measures, and intensive care. Indications for LT x in two children were progressive brain edema and cardiovascular failure. Children with FHF due to A. phalloides intoxication should be considered early for emergency LT x but should be monitored closely for the necessity of definite LT x. Early detoxification with active charcoal as well as silibinin and NAC seems to improve the outcome. Late recovery of liver function after day 4 post‐ingestion is possible.
    Type of Medium: Online Resource
    ISSN: 1397-3142 , 1399-3046
    URL: Issue
    URL: Article
    DOI: 10.1111/petr.2013.17.issue-6
    DOI: 10.1111/petr.12108
    Language: English
    Publisher: Wiley
    Publication Date: 2013
    detail.hit.zdb_id: 2008614-3
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