Defining Global Benchmarks for Robotic Liver Resections: An International Multicenter Study.

Objective: This study aimed to establish global benchmark outcomes indicators for robotic liver resections (R-LR).

Background: In recent years, minimally invasive liver resections and in particular R-LR has seen an increase in uptake in recent years. Although, benchmark outcomes have been recently established for laparoscopic (L) -LR, this has not been established for R-LR.

[Innovations in transplantation medicine].

More than 70 years after the first successful organ transplant between identical twins, transplantation medicine still faces significant challenges today: How can the large number of people waiting for a new kidney, liver, lung, or heart receive a suitable organ more quickly? How can survival on the waiting list be extended? How can long-term graft survival with high quality of life be ensured after transplantation? The various disciplines of transplantation medicine are working daily to address these challenges. The goal of this overview article is to provide practicing physicians with an overview of the current state and medium-term perspectives of transplantation medicine. For this purpose, an interdisciplinary team of transplantation experts from the largest transplant center in Germany has come together to summarize the current innovations and future perspectives of transplantation medicine in a compact and organ-overarching format.

Update on pediatric liver transplantation in Europe 2022: An ELITA-ESPGHAN report.

Objectives: The European Liver Transplant Registry (ELTR) has been collecting data on liver transplantation (LT) in Europe since 1968. The aim of this report is to outline the number, techniques utilized, indications for, and outcomes of pediatric LT (pLT) in Europe, focusing on the Year 2022 in comparison to the preceding 5 years.

Methods: Data were obtained from ELTR and Eurotransplant (ET).

Initial Experience with Dual-Time-Point [F]Flurpiridaz PET/CT for Localization of Parathyroid Adenomas in Primary Hyperparathyroidism.

We aimed to evaluate the feasibility of [F]flurpiridaz PET/CT for localization of parathyroid adenomas in patients with primary hyperparathyroidism (pHPT). Data for 11 patients with pHPT undergoing dual-time-point [F]flurpiridaz PET/CT for localization of hyperfunctioning parathyroid glands were retrospectively analyzed. PET/CT findings were compared with results of other imaging tests, laboratory parameters, intraoperative findings, and final histology, serving as the reference standard.

[Status of Robotics in Living Donor Liver and Kidney Transplantation - Review of the Literature and Results of a Survey among German Transplant Centres].

The advantages of minimally invasive surgical techniques are undisputed. With the introduction of robotic assistance systems, classic laparoscopy has been further developed and is now also being utilized in transplant surgery, which was previously mainly characterised by open surgical procedures, particularly in living donor liver and kidney donations. In order to assess the current implementation status of robotic assistance systems in transplant surgery, international studies in this field were summarized and correlated with a national survey on the use of robotic assistance systems in living donation.

Robotic Left Hepatectomy for Perihilar Cholangiocarcinoma.

Background: While robotic liver surgery has been widely established, major liver resection with biliary reconstruction remains challenging.

Methods: A 54-year-old female presenting with painless jaundice was diagnosed with a perihilar cholangiocarcinoma Bismuth IIIb. The indication for resection was confirmed by the multidisciplinary tumor board.

Combined Pancreas-kidney Transplantation After Rescue Allocation: The Eurotransplant Experience: A Retrospective Multicenter Outcome Analysis.

Background: Simultaneous pancreas-kidney transplantation (SPKT) is the therapy of choice for selected patients with complicated type 1 diabetes mellitus and end-stage renal disease. Pancreas rescue allocation was implemented in Eurotransplant allocation algorithms to increase organ utilization, concurrently facilitating transplantation of supposedly inferior quality organs. The aim of this study was to examine whether outcomes of SPKT after rescue allocation, which can either be recipient-oriented extended allocation or competitive rescue allocation, were as good as after standard allocation.

Early Allograft Dysfunction after liver transplantation- definition, incidence and relevance in a single-centre analysis.

Purpose: Early Allograft Dysfunction (EAD) is a serious complication following liver transplantation. With more marginal donors and critical recipients, identifying EAD risk factors and their impact on long-term outcomes is crucial.

Methods: We reviewed all liver transplants performed between 2007 and 2017 at our institution, excluding pediatric recipients, combined thoracic transplants, and retransplants in the same hospital stay.

Prediction of Renal Graft Function 1 Year After Adult Deceased-Donor Kidney Transplantation Using Variables Available Prior to Transplantation.

BACKGROUND Kidney transplantation is still the best therapy for patients with end-stage renal disease, but the demand for donor organs persistently surpasses the supply. A prognostic model using pre-transplant data for the prediction of renal graft function would be helpful to optimize organ allocation and avoid futile transplantations. MATERIAL AND METHODS Retrospective data of 2431 patients who underwent kidney transplantation between January 01, 2000, and December 31, 2012 with subsequent ten-year clinical follow-up in our transplant center were analyzed.

Omentoplasty for Cervical Lymphocele after Aortic Arch Replacement.

Lymphocele formation is a rare complication after surgical procedures involving the mediastinum. While uncomplicated lymphoceles show high rates of spontaneous closure and are usually treated conservatively, surgical treatment might be required in cases with persistent or recurrent lymphoceles. We present the case of a 53-year-old male with reoccurring cervical swelling after two surgeries of the thoracic aorta.

Extracellular NAD response to post-hepatectomy liver failure: bridging preclinical and clinical findings.

Liver fibrosis progressing to cirrhosis is a major risk factor for liver cancer, impacting surgical treatment and survival. Our study focuses on the role of extracellular nicotinamide adenine dinucleotide (eNAD) in liver fibrosis, analyzing liver disease patients undergoing surgery. Additionally, we explore NAD's therapeutic potential in a mouse model of extended liver resection and in vitro using 3D hepatocyte spheroids.

Resection of intrahepatic cholangiocarcinoma in octogenarians: a single-center analysis.

The rapidly aging population in industrialized countries comes with an increased incidence of intrahepatic cholangiocarcinoma (iCC) which presents new challenges for oncological treatments especially in elderly patients. Thus, the question arises to what extent the benefit of surgical resections, as the only curative treatment option, outweighs possible perioperative risks in patients ≥ 80 years of age (octogenarians). We therefore retrospectively analyzed 311 patients who underwent resection for iCC at Hannover Medical School between January 1996 and December 2022.

Cyclosporine vs. tacrolimus after liver transplantation for primary sclerosing cholangitis - a propensity score-matched intention-to-treat analysis.

Background & Aims: There is controversy regarding the optimal calcineurin inhibitor type after liver transplant(ation) (LT) for primary sclerosing cholangitis (PSC). We compared tacrolimus with cyclosporine in a propensity score-matched intention-to-treat analysis based on registries representing nearly all LTs in Europe and the US.

Methods: From the European Liver Transplant Registry (ELTR) and Scientific Registry of Transplant Recipients (SRTR), we included adult patients with PSC undergoing a primary LT between 2000-2020.

A surgical strategy for intrahepatic cholangiocarcinoma - the hilar first concept.

Purpose: The present study assesses long-term overall survival (OS) and disease-free survival (DFS) after curative resection for intrahepatic cholangiocarcinoma (ICCA) depending on resection margin (RM) status and lymph node (LN) status.

Methods: Clinical data of all consecutively resected patients with ICCA at a single high-volume center between 2005 and 2018 were collected. Minimum follow-up was 36 months.

Results from the european survey on preoperative management and optimization protocols for PeriHilar cholangiocarcinoma.

Background: Major surgery, along with preoperative cholestasis-related complications, are responsible for the increased risk of morbidity and mortality in perihilar cholangiocarcinoma (pCCA). The aim of the present survey is to provide a snapshot of current preoperative management and optimization strategies in Europe.

Methods: 61 European centers, experienced in hepato-biliary surgery completed a 59-questions survey regarding pCCA preoperative management.