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Biomedical subjects

L Röhl

Publications and source records attributed to L Röhl.

At least 19 recordsLinked to original sources
PubMed1994

[Local recurrence after organ saving kidney tumor surgery].

Although excellent survival rates for nephron-sparing surgery in mandatory indications (solitary kidney, bilateral renal neoplasms) have been documented, parenchymasparing surgery in elective indications (normal contralateral kidney) is a point of controversy. Local tumor recurrence is the most important argument against this approach. From January 1971 to December 1989, 107 patients suffering from renal cell carcinoma in solitary kidneys or bilateral renal carcinoma underwent nephron-sparing surgery. Thirteen patients (12%) suffered from local recurrence between 4 and 112 months after tumor resection. A high proportion of these recurrences were seen within the first 2 years after resection, followed by a almost linear increase thereafter. Thus-there are possibly two different entities for local recurrence. A correlation between tumor grade and interval from resection to local recurrence could be found, with a long average interval for grade 1 tumors--longer than the published follow-up times for patients undergoing elective tumor resections. Although most of the patients described in this report do not fulfil the surgical criteria for elective resection, we cannot recommend parenchyma-sparing surgery in elective indications.

Adult↗
PubMed1985

[Causes of hypertension following kidney transplantation with special reference to arterial stenoses].

Hypertension is regarded as a significant complication in renal transplant recipients. Its frequency was 48,1% after cadaver donor and 40,6% after living donor transplantation. The etiology is multifactorial. A correlation could be demonstrated between blood pressure and graft function or presence or absence of the diseased kidneys while no influence was found with regard to steroid dosage in patients with long term graft function. After 575 renal transplantations with 147 angiographies arterial stenoses were observed in nine patients (1,6%) and corrected surgically.

Adolescent↗
PubMed1983

[Report of experiences with therapy of kidney injuries].

Of 510 traumatic renal injuries analyzed for the period 1960-1982, 95 patients demonstrated an injury of grade I-V according to the classification of Küster[11]. 88 patients were treated by surgery, 73 had immediate exploration. 15 patients in whom surgery became necessary after a trial of non operative management demonstrated much more complications than those managed by early operative intervention. Nephrectomy had to be performed in 8 of these 15 patients. The value of early excretory urography, ultrasound and sometimes of CT in the diagnosis of renal injuries is discussed. Arteriography and retrograde pyelography are only useful in very selected cases.

Humans↗
PubMed1980

48- to 96-hour preservation of canine kidneys by initial perfusion and hypothermic storage using the Euro-Collins solution.

In 1976 a standardised hypertonic 'intracellular' perfusate (Euro-Collins solution) was recommended for renal preservation in all donor centres collaborating with the Eurotransplant Organisation. In order to investigate the effectiveness of this perfusate canine kidneys were initially flushed with Euro-Collins solution and subjected to 48, 72 and 96 h of cold storage and autotransplantated. Immediate contralateral nephrectomy was performed after autotransplantation. The serum creatinine served as a parameter of postoperative renal function. Under laboratory conditions successful preservation was achieved after minimal (less than 5 min) warm ischaemia for up to 96 h of cold ischaemia and after 15 min of warm ischaemia for up to 48 h of cold ischaemia. Our results suggest that initial flushing and hypothermic storage of kidneys using Euro-Collins solution is a satisfactory preservation method when human cadaver kidneys can be harvested under adequate conditions.

Animals↗
PubMed1980

Results of kidney transplantation in relation to HLA-A, B, DR matching and quality of donor organ.

The influence of HLA compatibility as well as immediate postoperative function on survival rates was investigated in 203 cadaver kidney transplants. HLA compatibility, especially DR compatibility, improved transplant survival significantly. A direct correlation was found between primary transplant function and long-term results. HLA compatibility and quality of the donor organ had a cumulative effect on kidney transplant survival. Our results are a further indication that besides HLA compatibility, optimal quality of donor organs has crucial significance for the results of transplantation.

Follow-Up Studies↗
PubMed1980

Prognostic significance of B and T cell antibodies in kidney transplantation.

The prognostic significance of pre- and post-transplant B and T cell antibodies was studied in 183 cadaver kidney transplantations. Our results confirm previous reports that a successful kidney transplantation can be carried out in spite of a positive crossmatch due to B cell antibodies. However, it is doubtful whether such antibodies have a protective effect. The success rate seemed to be higher only in patients with preformed cold antibodies. The occurrence and persistence of allogeneic anti-donor antibodies directed against T cells was significantly associated with an unfavourable graft prognosis. Patients with post-transplant anti-donor B cell antibodies had lower (but not significantly) graft survival rates. These findings provide additional evidence for a crucial role of anti-donor antibodies in kidney graft outcome.

Antibodies↗
PubMed1979

Alloplastic replacement of the partially resected canine urethra by expanded polytetrafluoroethylene grafts. Preliminary results.

In 12 male dogs 3-8 cm of the penile urethra were resected and replaced by expanded polytetrafluoroethylene (GORE-TEX) grafts. Follow-up consisted of periodic urethrograms. Maximum observation time has been 12 months. Up to now, no major complications were noted. Tissue reactions were minimal and patency of all grafts was demonstrated during the follow-up period.

Animals↗
PubMed1979

Urodynamic studies in prune belly syndrome. A case report.

Urodynamic studies were carried out in a 14-year-old boy with Prune Belly Syndrome and terminal renal failure prior and after successful renal transplantation. Increased bladder capacity, nonprovocative detrusor instability and a high compliance were the most characteristic findings during the filling phase of the bladder. During the voiding phase an increased detrusor pressure was demonstrated. Outflow resistance and maximum urinary flow rate were within normal range before and after transplantation. In contrast to the findings before renal transplantation, however, micturition was imbalanced after transplantation (residual urine 100 ml). Urodynamics revealed that the bulging of the posterior urethra, observed in the early voiding phase, was due to a congenital insufficiency of the posterior urethral musculature (megalourethra) and not caused by mechanical obstruction leading to urethral dilatation. It is suggested that detrusor-bladder-neck-dyssynergia is the primary cause of the imbalanced micturition and its consequences (bladder distention, reflux, urinary tract infection, hydronephrosis, pyelonephritis) in patients with Prune Belly Syndrome. The findings of a normal, respectively increased detrusor activity are in contrast to the observations of some authors, describing attenutation and absence of detrusor muscle fibres. The indications and effects of transurethral resection and internal urethrotomy, proposed by some authors, are discussed.

Abdominal Muscles↗
PubMed1979

[Organ preserving surgical treatment of solitary and bilateral renal tumors].

The surgical treatment of patients with tumours in solitary kidneys and bilateral renal tumours is controversial. Conservative surgical procedures by excision of the tumour in situ or by extracorporeal "work bench surgery" with subsequent autotransplantation are a real alternative to radical nephrectomy which necessitates chronic dialysis or renal allotransplantation. 23 patients with tumours in solitary kidneys resp. bilateral renal tumours have been treated by local excision in situ (10 patients) or extracorporeal surgery (15 patients). The preoperative diagnostic investigations, indications for in situ resp. extracorporeal surgery, details of the operative procedure and results of treatment are presented and discussed.

Carcinoma↗
PubMed1979

[Conservative surgery of spontaneous rupture of renal grafts].

17 cases of spontaneous rupture of renal allografts were noted after 285 renal transplantations performed during the years 1967-1978. All ruptures occurred within the first two weeks after transplantation. Acute rejection, combined with hypertension, dialysis and/or anticoagulation seem to be the main etiological factors of graft rupture. Due to severe hemorrhage surgical exploration had to be performed in 15 patients. While removal of the graft was necessary in 4 patients the kidney could be preserved by tamponade and suture in 11 patients. 5 patients later lost their graft, due to chronic rejection, while 8 patients (6 of the 15 patients who needed surgical exploration) currently have satisfactory graft function.

Anticoagulants↗