PubMed Health⌕ Search

Biomedical subjects

B Rodeck

Publications and source records attributed to B Rodeck.

44 records · Page 3Linked to original sources

Experience with partial liver transplantation in Hannover.

Within a 7-year period 37 PLTx have been performed in 32 patients (25 children, 7 adults). Age at the time of operation was 5 years in two-thirds of all cases (23 of 37). Indications were elective in 17 patients and urgent in 20. The following types of PLTx were used: a LLL in 24 cases, a LL in 9, and a RL in 4. Three donor livers were split and transplanted into 2 recipients each. The body weight ratio between donors and recipients ranged from 0.9:1 to 12.3:1. Nineteen of 26 adult-donor livers were transplanted into pediatric recipients. Patient and graft survival following elective PLTx at 2 years was 69.7% and 50.5%, respectively, which was not significantly different from the results following urgent transplantation. Overall, 30-day mortality was 18.8% (6 of 32 patients) and was relative to the patients' clinical status at the time of transplantation. Graft loss in 29.7% (11 of 37 transplants) was due to liver-related causes such as chronic rejection (n = 5) and primary nonfunction (n = 4). Postoperative surgical complications were noted in 13 cases but were not different from those seen with WLTx. At present, 19 of 32 recipients (59.4%) are alive between 1 and 43 months following transplantation.

Adolescent↗

[Stabilization of lung function in cystic fibrosis during long-term tube feeding via a percutaneous endoscopic gastrostomy].

To determine whether long-term enteral feedings can improve nutritional status and lung function parameters in patients with cystic fibrosis (CF), 11 patients (8 female, 3 male, age 7 to 23 years) received a percutaneous endoscopic gastrostomy (PEG) since February 1988. All patients were moderately to severely affected and extremely malnourished with a relative underweight of 15% or more. After 9 months of supplemental nocturnal feeding, mean body weight improved from 25.8 +/- 4.7 kg (mean, standard deviation) to 31.6 +/- 7.4 kg (p = 0.003); mean relative underweight decreased from 20.7 +/- 3.4% to 10.4 +/- 8.6% (p = 0.02). Lung function, which was measured either prior to or without any intravenous antibiotics, improved considerably: mean vital capacity increased from 39.5% of the predicted value to 46.8% after 9 months (p = 0.01), the mean peak flow rate improved from 39.5% to 50.8% (p = 0.01). This improvement in lung function is probably secondary to the increased muscle mass of the patients. Long-term nocturnal feedings via a percutaneous gastrostomy tube improve nutritional status and lung function severely in malnourished patients with CF.

Adolescent↗

[Long-term ursodeoxycholic acid treatment of cholestatic liver diseases in childhood--clinical and biochemical effects].

BACKGROUND: In adults with chronic cholestatic liver disorders, controlled studies have shown a reduction of clinical, biochemical and possibly histological parameters during long-term medication with ursodeoxycholic acid (UDCA). It is not yet clear, however, whether similar effects can be achieved in children. Therefore, we retrospectively evaluated the use of UDCA in typical liver diseases of childhood. METHOD: 20 children were treated for at least 6 months (age at start of therapy 5-87, median 24 months; diagnosis: biliary atresia n = 10, Alagille's syndrome n = 4, intrahepatic biliary hypoplasia n = 3, Byler disease n = 3). Pruritus, liver cell injury, cholestasis, synthetic liver function and weight and height for age before medication with UDCA (7-26, mean 13 mg/kg BW/d) was compared to values after 3, 6, 12, 18 and 24 months of therapy, with special attention towards possible adverse effects. RESULTS: No adverse effects of UDCA necessitating modification of therapy were encountered. During the first year of medication, weight for age improved in 15 patients, but pruritus in only four. During UDCA treatment, GIDH and gamma GT decreased significantly. GOT and GPT declined in the majority of patients. No significant changes of bilirubin and parameters of liver synthesis were seen. CONCLUSION: Long-term medication with UDCA appears to be safe in children. Thus, controlled studies of UDCA medication in children are justified, and are urgently needed to further investigate the prognostic significance of the positive effects of UDCA identified in this retrospective analysis.

Alagille Syndrome↗

Psychological support of children undergoing liver transplantation and their parents: a single-centre experience.

Children undergoing liver transplantation, and their parents, are regularly provided with psychological support by a team of social workers and psychologists in the Children's Hospital of the Medical School Hannover, Germany. We would like to highlight the structure of this psychosocial care and its development since the first liver transplantation in 1978. As most of the stress related to the procedures of transplantation is inevitable, emotional support provided by such a team approach is essential.

Adaptation, Psychological↗