Pankreastransplantation – Klinik, Technik und histologische Beurteilung Article Swipe
Maike Büttner‐Herold
,
Kerstin Amann
,
Frederick Pfister
,
Andrea Tannapfel
,
M. V. Maslova
,
Andreas Wünsch
,
Nina Pillokeit
,
Richard Viebahn
,
Peter Schenker
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1007/s00292-021-00982-1
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1007/s00292-021-00982-1
Zusammenfassung Hintergrund Die Pankreastransplantation wird in Deutschland nur in wenigen ausgewählten Zentren durchgeführt, üblicherweise in Kombination mit einer Niere. Die Kenntnis von Indikationen und Techniken der Transplantation selbst als auch der histopathologischen Abstoßungsdiagnostik mittels Pankreas- oder selten Duodenalbiopsie ist nicht sehr weit verbreitet. Ziel der Arbeit Darstellung der Entwicklung und des aktuellen Stands der Pankreas-Nieren-Transplantation in Deutschland anhand der Erfahrungen des größten deutschen Zentrums und Analyse der Ergebnisse der zwischen 06/2017 und 12/2020 durchgeführten Abstoßungsbiopsien inklusive ausführlicher Darstellung und Bebilderung der verschiedenen Abstoßungskategorien Material und Methode Es wurde eine ausführliche Literaturrecherche zur Historie, Technik und Indikation der Pankreastransplantation durchgeführt und die technischen Besonderheiten und Erfahrungen am Bochumer Zentrum, insbesondere auch die Komplikationen, im internationalen Vergleich dargestellt. Desweiteren wurden alle im Zeitraum zwischen 06/2017 und 12/2020 durchgeführten Pankreas- oder Duodenalbiopsien, die zur Abstoßungsdiagnostik nach Erlangen gegangen waren und mittels der Banff-Klassifikation standardisiert bearbeitet wurden, anhand der vorliegenden Befunde ausgewertet und zusammenfassend dargestellt. Zum besseren Verständnis wurden die wichtigsten histologischen Entitäten bildhaft dargestellt und differenzialdiagnostische Aspekte diskutiert. Ergebnisse Insgesamt wurden 93 Pankreastransplantat- und 3 Duodenalbiopsien untersucht. In 32 Pankreasbiopsien, d.h. 34,4 %, war kein diagnostisch verwertbares Material enthalten. Bei den verbliebenen 61 Pankreasbiopsien fanden sich bei 24,6 % keine Abstoßungszeichen, 62,3 % eine akute T-Zell-vermittelte Abstoßungsreaktion (TCMR) und 8,2 % Hinweise auf eine aktive Antikörper-vermittelte Abstoßung (ABMR). Ein akuter Azinuszellschaden wurde in 59 % der Biopsien gesehen, eine Pankreatitis in 8,2 % und eine Allograft-Fibrose in immerhin 54,1 %. Die Calcineurin-Inhibitor (CNI) Toxizität war mit 4,9% eher selten. Schlussfolgerung Die Pankreas-Nieren-Transplantation inklusive der Biopsie des transplantierten Pankreas oder in seltenen Fällen auch des Spenderduodenums mit anschließender standardisierter Beurteilung entsprechend der aktuellen international gültigen Banff-Klassifikation der Pankreasabstoßung und der Empfehlungen zur Beurteilung von Duodenalbiopsien hat ihren festen Stellenwert in der Behandlung von Diabetikern.
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- Type
- review
- Language
- de
- Landing Page
- https://doi.org/10.1007/s00292-021-00982-1
- https://link.springer.com/content/pdf/10.1007/s00292-021-00982-1.pdf
- OA Status
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- Cited By
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- Related Works
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- OpenAlex ID
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https://openalex.org/W3193799225Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1007/s00292-021-00982-1Digital Object Identifier
- Title
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Pankreastransplantation – Klinik, Technik und histologische BeurteilungWork title
- Type
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reviewOpenAlex work type
- Language
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dePrimary language
- Publication year
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2021Year of publication
- Publication date
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2021-08-20Full publication date if available
- Authors
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Maike Büttner‐Herold, Kerstin Amann, Frederick Pfister, Andrea Tannapfel, M. V. Maslova, Andreas Wünsch, Nina Pillokeit, Richard Viebahn, Peter SchenkerList of authors in order
- Landing page
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https://doi.org/10.1007/s00292-021-00982-1Publisher landing page
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https://link.springer.com/content/pdf/10.1007/s00292-021-00982-1.pdfDirect link to full text PDF
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YesWhether a free full text is available
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hybridOpen access status per OpenAlex
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https://link.springer.com/content/pdf/10.1007/s00292-021-00982-1.pdfDirect OA link when available
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Medicine, Pancreas, Context (archaeology), Pancreas transplantation, Biopsy, Transplantation, Differential diagnosis, General surgery, Pathology, Kidney transplantation, Internal medicine, Paleontology, BiologyTop concepts (fields/topics) attached by OpenAlex
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3Total citation count in OpenAlex
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2023: 3Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.technischen | 101 |
| abstract_inverted_index.untersucht. | 173 |
| abstract_inverted_index.verbreitet. | 42 |
| abstract_inverted_index.wichtigsten | 156 |
| abstract_inverted_index.Diabetikern. | 289 |
| abstract_inverted_index.Empfehlungen | 276 |
| abstract_inverted_index.Indikationen | 22 |
| abstract_inverted_index.Pankreatitis | 226 |
| abstract_inverted_index.Verständnis | 153 |
| abstract_inverted_index.dargestellt. | 115, 150 |
| abstract_inverted_index.diagnostisch | 182 |
| abstract_inverted_index.entsprechend | 266 |
| abstract_inverted_index.insbesondere | 108 |
| abstract_inverted_index.verbliebenen | 188 |
| abstract_inverted_index.verwertbares | 183 |
| abstract_inverted_index.vorliegenden | 145 |
| abstract_inverted_index.ausführliche | 89 |
| abstract_inverted_index.ausgewählten | 10 |
| abstract_inverted_index.durchgeführt | 98 |
| abstract_inverted_index.international | 269 |
| abstract_inverted_index.verschiedenen | 81 |
| abstract_inverted_index.Besonderheiten | 102 |
| abstract_inverted_index.ausführlicher | 76 |
| abstract_inverted_index.durchgeführt, | 12 |
| abstract_inverted_index.histologischen | 157 |
| abstract_inverted_index.standardisiert | 140 |
| abstract_inverted_index.üblicherweise | 13 |
| abstract_inverted_index.Duodenalbiopsie | 37 |
| abstract_inverted_index.Komplikationen, | 111 |
| abstract_inverted_index.Transplantation | 26 |
| abstract_inverted_index.Zusammenfassung | 0 |
| abstract_inverted_index.anschließender | 263 |
| abstract_inverted_index.durchgeführten | 73, 125 |
| abstract_inverted_index.internationalen | 113 |
| abstract_inverted_index.zusammenfassend | 149 |
| abstract_inverted_index.Duodenalbiopsien | 172, 280 |
| abstract_inverted_index.Pankreasbiopsien | 190 |
| abstract_inverted_index.Schlussfolgerung | 246 |
| abstract_inverted_index.Spenderduodenums | 261 |
| abstract_inverted_index.standardisierter | 264 |
| abstract_inverted_index.transplantierten | 253 |
| abstract_inverted_index.Allograft-Fibrose | 232 |
| abstract_inverted_index.Azinuszellschaden | 217 |
| abstract_inverted_index.Duodenalbiopsien, | 128 |
| abstract_inverted_index.Pankreasbiopsien, | 176 |
| abstract_inverted_index.Literaturrecherche | 90 |
| abstract_inverted_index.Pankreasabstoßung | 273 |
| abstract_inverted_index.T-Zell-vermittelte | 202 |
| abstract_inverted_index.Abstoßungsbiopsien | 74 |
| abstract_inverted_index.Abstoßungsreaktion | 203 |
| abstract_inverted_index.Abstoßungszeichen, | 197 |
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| abstract_inverted_index.Banff-Klassifikation | 139, 271 |
| abstract_inverted_index.Abstoßungsdiagnostik | 32, 131 |
| abstract_inverted_index.Abstoßungskategorien | 82 |
| abstract_inverted_index.Calcineurin-Inhibitor | 238 |
| abstract_inverted_index.Pankreastransplantat- | 169 |
| abstract_inverted_index.Antikörper-vermittelte | 212 |
| abstract_inverted_index.Pankreastransplantation | 3, 97 |
| abstract_inverted_index.differenzialdiagnostische | 162 |
| abstract_inverted_index.Pankreas-Nieren-Transplantation | 54, 248 |
| cited_by_percentile_year.max | 97 |
| cited_by_percentile_year.min | 96 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 9 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.6200000047683716 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.62712477 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |