Subject(s)
Azathioprine/therapeutic use , Cyclosporine/therapeutic use , Kidney Transplantation/physiology , Pancreas Transplantation/physiology , Adult , Antilymphocyte Serum/therapeutic use , Creatinine/blood , Diabetes Mellitus, Type 1/surgery , Diabetic Nephropathies/surgery , Drug Therapy, Combination , Female , Follow-Up Studies , Graft Rejection/drug therapy , Graft Rejection/epidemiology , Humans , Kidney Failure, Chronic/surgery , Kidney Transplantation/immunology , Male , Middle Aged , Mycophenolic Acid/analogs & derivatives , Mycophenolic Acid/therapeutic use , Pancreas Transplantation/immunology , Prednisolone/therapeutic use , Prednisone/therapeutic use , Tacrolimus/therapeutic use , Time Factors , Treatment Failure , Treatment OutcomeABSTRACT
Clinical liver transplantation became an established therapy of end-stage liver disease since the first at least medium-term successful liver transplantation in 1967. Clinical studies have played a major part in improving peri- and postoperative therapy in liver transplantation. In this article clinical studies of major impact are presented. Main topics are studies dealing with immunosuppressants, improvements in surgical techniques, viral infections and tumor diseases. Controlled randomized multicentric studies are rare; most of the studies are unicentric. Further studies in the fields of reducing side effects of immunosuppression, the introduction of monoclonal antibodies and improvement of the therapy of viral hepatitis would be helpful. These studies should be controlled, randomized and multicentric.
Subject(s)
Liver Transplantation , Multicenter Studies as Topic , Randomized Controlled Trials as Topic , Carcinoma, Hepatocellular/surgery , Cyclosporine/therapeutic use , Cytomegalovirus Infections/complications , Cytomegalovirus Infections/etiology , Double-Blind Method , Hepatitis B/complications , Hepatitis B/etiology , Hepatitis C/complications , Hepatitis C/etiology , Humans , Immunosuppression Therapy , Immunosuppressive Agents/therapeutic use , Liver Neoplasms/surgery , Liver Transplantation/adverse effects , Liver Transplantation/methods , Postoperative Complications , Prognosis , Prospective Studies , Tacrolimus/therapeutic useABSTRACT
From May 1993 to September 1997 we treated 22 patients with complications after laparoscopic surgery. We report on 18 patients after laparoscopic cholecystectomy, three patients after diagnostic laparoscopy and one after TAPP. Two patients died (hepatic failure and without any possibility of definitive therapy) and the injuries of the other 20 patients were repaired.