TY  - JOUR
A1  - Assfalg, Volker
A1  - Selig, Katharina
A1  - Tolksdorf, Johanna
A1  - van Meel, Marieke
A1  - de Vries, Erwin
A1  - Ramsoebhag, Anne‐Marie
A1  - Rahmel, Axel
A1  - Renders, Lutz
A1  - Novotny, Alexander
A1  - Matevossian, Edouard
A1  - Schneeberger, Stefan
A1  - Rosenkranz, Alexander R.
A1  - Berlakovich, Gabriela
A1  - Ysebaert, Dirk
A1  - Knops, Noël
A1  - Kuypers, Dirk
A1  - Weekers, Laurent
A1  - Muehlfeld, Anja
A1  - Rump, Lars‐Christian
A1  - Hauser, Ingeborg
A1  - Pisarski, Przemyslaw
A1  - Weimer, Rolf
A1  - Fornara, Paolo
A1  - Fischer, Lutz
A1  - Kliem, Volker
A1  - Sester, Urban
A1  - Stippel, Dirk
A1  - Arns, Wolfgang
A1  - Hau, Hans‐Michael
A1  - Nitschke, Martin
A1  - Hoyer, Joachim
A1  - Thorban, Stefan
A1  - Weinmann‐Menke, Julia
A1  - Heller, Katharina
A1  - Banas, Bernhard
A1  - Schwenger, Vedat
A1  - Nadalin, Silvio
A1  - Lopau, Kai
A1  - Hüser, Norbert
A1  - Heemann, Uwe
T1  - Repeated kidney re‐transplantation—the Eurotransplant experience: a retrospective multicenter outcome analysis
JF  - Transplant International
N2  - In Eurotransplant kidney allocation system (ETKAS), candidates can be considered unlimitedly for repeated re‐transplantation. Data on outcome and benefit are indeterminate. We performed a retrospective 15‐year patient and graft outcome data analysis from 1464 recipients of a third or fourth or higher sequential deceased donor renal transplantation (DDRT) from 42 transplant centers. Repeated re‐DDRT recipients were younger (mean 43.0 vs. 50.2 years) compared to first DDRT recipients. They received grafts with more favorable HLA matches (89.0% vs. 84.5%) but thereby no statistically significant improvement of patient and graft outcome was found as comparatively demonstrated in 1st DDRT. In the multivariate modeling accounting for confounding factors, mortality and graft loss after 3rd and ≥4th DDRT (P < 0.001 each) and death with functioning graft (DwFG) after 3rd DDRT (P = 0.001) were higher as compared to 1st DDRT. The incidence of primary nonfunction (PNF) was also significantly higher in re‐DDRT (12.7%) than in 1st DDRT (7.1%; P < 0.001). Facing organ shortage, increasing waiting time, and considerable mortality on dialysis, we question the current policy of repeated re‐DDRT. The data from this survey propose better HLA matching in first DDRT and second DDRT and careful selection of candidates, especially for ≥4th DDRT.
KW  - allocation
KW  - child
KW  - fourth
KW  - graft
KW  - kidney
KW  - loss
KW  - repeated
KW  - re‐transplantation
KW  - survival
KW  - third
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-214161
VL  - 33
IS  - 6
SP  - 617
EP  - 631
ER  - 
TY  - JOUR
A1  - Augustin, Anne Marie
A1  - Welsch, Stefan
A1  - Bley, Thorsten Alexander
A1  - Lopau, Kai
A1  - Kickuth, Ralph
T1  - Color-coded summation images in the evaluation of renal artery stenosis before and after percutaneous transluminal angioplasty
JF  - BMC Medical Imaging
N2  - Background: Endovascular therapy is the gold standard in patients with hemodynamic relevant renal artery stenosis (RAS) resistant to medical therapy. The severity grading of the stenosis as well as the result assessment after endovascular approach is predominantly based on visible estimations of the anatomic appearance. We aim to investigate the application of color-coded DSA parameters to gain hemodynamic information during endovascular renal artery interventions and for the assessment of the procedures technical success. 
Methods: We retrospectively evaluated 32 patients who underwent endovascular renal artery revascularization and applied color-coded summation imaging on selected monochromatic DSA images. The differences in time to peak (dTTP) of contrast enhancement in predefined anatomical measuring points were analyzed. Furthermore, differences in systolic blood pressure values (SBP) and serum creatinine were obtained. The value of underlying diabetes mellitus as a predictor for clinical outcome was assessed. Correlation analysis between the patients gender as well as the presence of diabetes mellitus and dTTP was performed. 
Results: Endovascular revascularization resulted in statistically significant improvement in 4/7 regions of interest. Highly significant improvement of perfusion in terms of shortened TTP values could be found at the segmental artery level and in the intrastenotical segment (p<0.001), significant improvement prestenotical and in the apical renal parenchyma (p<0.05). In the other anatomic regions, differences revealed not to be significant. Differences between SBP and serum creatinine levels before and after the procedure were significant (p=0.004 and 0.0004). Patients ' gender as well as the presence of diabetes mellitus did not reveal to be predictors for the clinical success of the procedure. Furthermore, diabetes and gender did not show relevant correlation with dTTP in the parenchymal measuring points.
Conclusions: The supplementary use of color-coding DSA and the data gained from parametric images may provide helpful information in the evaluation of the procedures ' technical success. The segmental artery might be a particularly suitable vascular territory for analyzing differences in blood flow characteristics. Further studies with larger cohorts are needed to further confirm the diagnostic value of this technique.
KW  - digital subtraction angiography
KW  - color-coded
KW  - endovascular
KW  - renal artery
KW  - PTA
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259086
VL  - 21
IS  - 1
ER  -