9 results on '"Stocker, Felix"'
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2. Kidney Transplantation after Rescue Allocation - The Eurotransplant Experience
- Author
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Assfalg, Volker, Miller, Gregor, Stocker, Felix, van Meel, Marieke, Groenevelt, Tiny, Tieken, Ineke, Ankerst, Donna, Renders, Lutz, Novotny, Alexander, Hartmann, Daniel, Jell, Alissa, Rahmel, Axel, Wahba, Roger, Mühlfeld, Anja, Bouts, Antonia, Ysebaert, Dirk, Globke, Brigitta, Jacobs-Tulleneers-Thevissen, Daniel, Piros, László, Stippel, Dirk, Heller, Katharina, Eisenberger, Ute, van Laecke, Steven, Weimer, Rolf, Rosenkranz, Alexander R., Berger, Stefan, Fischer, Lutz, Kliem, Volker, Vondran, Florian, Sester, Urban, Schneeberger, Stefan, Harth, Ana, Kuypers, Dirk, Függer, Reinhold, Arnol, Miha, Christiaans, Maarten, Weinmann-Menke, Julia, Krüger, Bernd, Hilbrands, Luuk, Banas, Bernhard, Hakenberg, Oliver, Minnee, Robert, Schwenger, Vedat, Heyne, Nils, van Zuilen, Arjan, Reindl-Schwaighofer, Roman, Lopau, Kai, Hüser, Norbert, Heemann, Uwe, Huüser, Norbert, Surgery, Groningen Kidney Center (GKC), Groningen Institute for Organ Transplantation (GIOT), Paediatric Nephrology, ARD - Amsterdam Reproduction and Development, Interne Geneeskunde, MUMC+: MA Nefrologie (9), RS: NUTRIM - R3 - Respiratory & Age-related Health, Pediatrics, Basic (bio-) Medical Sciences, and Diabetes Pathology & Therapy
- Subjects
Waiting time ,kidney ,PREDICTOR ,medicine.medical_specialty ,Tissue and Organ Procurement ,Eurotransplant ,medicine.medical_treatment ,Medizin ,Outcome analysis ,deceased donor renal transplantation ,COLD ISCHEMIA TIME ,surgery ,All institutes and research themes of the Radboud University Medical Center ,Internal medicine ,DIALYSIS ,Medicine and Health Sciences ,Humans ,Medicine ,standard allocation ,FRAILTY ,Kidney transplantation ,Dialysis ,Retrospective Studies ,RISK ,GRAFT FAILURE ,Transplantation ,Deceased donor ,rescue allocation ,business.industry ,MORTALITY ,Incidence (epidemiology) ,Graft Survival ,algorithms Eurotransplant kidney allocation system ,ASSOCIATION ,medicine.disease ,Kidney Transplantation ,Tissue Donors ,Confidence interval ,Eurotransplant senior program ,RECIPIENTS ,Treatment Outcome ,SURVIVAL ,Human medicine ,Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] ,business - Abstract
BACKGROUND: At Eurotransplant (ET), kidneys are transferred to "rescue allocation" (RA), whenever the standard allocation (SA) algorithms Eurotransplant Kidney Allocation System (ETKAS) and Eurotransplant Senior Program (ESP) fail. We analyzed the outcome of RA. METHODS: Retrospective patient clinical and demographic characteristics association analyses were performed with graft outcomes for 2422 recipients of a deceased donor renal transplantation (DDRT) after RA versus 25 481 after SA from 71 centers across all ET countries from 2006 to 2018. RESULTS: Numbers of DDRTs after RA increased over the time, especially in Germany. RA played a minor role in ESP versus ETKAS (2.7% versus 10.4%). RA recipients and donors were older compared with SA recipients and donors, cold ischemia times were longer, waiting times were shorter, and the incidence of primary nonfunction was comparable. Among ETKAS recipients, HLA matching was more favorable in SA (mean 3.7 versus 2.5). In multivariate modeling, the incidence of graft loss in ETKAS recipients was reduced in RA compared with SA (subdistribution hazard ratio, 0.80; 95% confidence interval [0.70-0.91], P
- Published
- 2022
3. Kidney Transplantation After Rescue Allocation-the Eurotransplant Experience: A Retrospective Multicenter Outcome Analysis
- Author
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Assfalg, Volker, Miller, Gregor, Stocker, Felix, Meel, Marieke van, Groenevelt, Tiny, Tieken, Ineke, Berger, Stefan, Hilbrands, L.B., Hueser, Norbert, Heemann, Uwe, Assfalg, Volker, Miller, Gregor, Stocker, Felix, Meel, Marieke van, Groenevelt, Tiny, Tieken, Ineke, Berger, Stefan, Hilbrands, L.B., Hueser, Norbert, and Heemann, Uwe
- Abstract
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- Published
- 2022
4. Kidney Transplantation after Rescue Allocation - The Eurotransplant Experience:A Retrospective Multicenter Outcome Analysis
- Author
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Assfalg, Volker, Miller, Gregor, Stocker, Felix, Van Meel, Marieke, Groenevelt, Tiny, Tieken, Ineke, Ankerst, Donna, Renders, Lutz, Novotny, Alexander, Hartmann, Daniel, Jell, Alissa, Rahmel, Axel, Wahba, Roger, Mühlfeld, Anja, Bouts, Antonia, Ysebaert, Dirk, Globke, Brigitta, Jacobs-Tulleneers-Thevissen, Daniel, Piros, László, Stippel, Dirk, Heller, Katharina, Eisenberger, Ute, Van Laecke, Steven, Weimer, Rolf, Rosenkranz, Alexander R., Berger, Stefan, Fischer, Lutz, Kliem, Volker, Vondran, Florian, Sester, Urban, Schneeberger, Stefan, Harth, Ana, Kuypers, Dirk, Függer, Reinhold, Arnol, Miha, Christiaans, Maarten, Weinmann-Menke, Julia, Krüger, Bernd, Hilbrands, Luuk, Banas, Bernhard, Hakenberg, Oliver, Minnee, Robert, Schwenger, Vedat, Heyne, Nils, Van Zuilen, Arjan, Reindl-Schwaighofer, Roman, Lopau, Kai, Huser, Norbert, Heemann, Uwe, Assfalg, Volker, Miller, Gregor, Stocker, Felix, Van Meel, Marieke, Groenevelt, Tiny, Tieken, Ineke, Ankerst, Donna, Renders, Lutz, Novotny, Alexander, Hartmann, Daniel, Jell, Alissa, Rahmel, Axel, Wahba, Roger, Mühlfeld, Anja, Bouts, Antonia, Ysebaert, Dirk, Globke, Brigitta, Jacobs-Tulleneers-Thevissen, Daniel, Piros, László, Stippel, Dirk, Heller, Katharina, Eisenberger, Ute, Van Laecke, Steven, Weimer, Rolf, Rosenkranz, Alexander R., Berger, Stefan, Fischer, Lutz, Kliem, Volker, Vondran, Florian, Sester, Urban, Schneeberger, Stefan, Harth, Ana, Kuypers, Dirk, Függer, Reinhold, Arnol, Miha, Christiaans, Maarten, Weinmann-Menke, Julia, Krüger, Bernd, Hilbrands, Luuk, Banas, Bernhard, Hakenberg, Oliver, Minnee, Robert, Schwenger, Vedat, Heyne, Nils, Van Zuilen, Arjan, Reindl-Schwaighofer, Roman, Lopau, Kai, Huser, Norbert, and Heemann, Uwe
- Abstract
Background. At Eurotransplant (ET), kidneys are transferred to "rescue allocation" (RA), whenever the standard allocation (SA) algorithms Eurotransplant Kidney Allocation System (ETKAS) and Eurotransplant Senior Program (ESP) fail. We analyzed the outcome of RA. Methods. Retrospective patient clinical and demographic characteristics association analyses were performed with graft outcomes for 2422 recipients of a deceased donor renal transplantation (DDRT) after RA versus 25 481 after SA from 71 centers across all ET countries from 2006 to 2018. Results. Numbers of DDRTs after RA increased over the time, especially in Germany. RA played a minor role in ESP versus ETKAS (2.7% versus 10.4%). RA recipients and donors were older compared with SA recipients and donors, cold ischemia times were longer, waiting times were shorter, and the incidence of primary nonfunction was comparable. Among ETKAS recipients, HLA matching was more favorable in SA (mean 3.7 versus 2.5). In multivariate modeling, the incidence of graft loss in ETKAS recipients was reduced in RA compared with SA (subdistribution hazard ratio, 0.80; 95% confidence interval [0.70-0.91], P < 0.001), whereas other outcomes (mortality, death with functioning graft (DwFG)) were not significantly different. None of the 3 outcomes were significantly different when comparing RA with SA within the ESP program. Conclusions. Facing increased waiting times and mortality on dialysis due to donor shortage, this study reveals encouragingly positive DDRT outcomes following RA. This supports the extension of RA to more patients and as an alternative tool to enable transplantation in patients in countries with prohibitively long waiting times or at risk of deterioration.
- Published
- 2022
5. Kidney Transplantation after Rescue Allocation - the Eurotransplant Experience: A Retrospective Multicenter Outcome Analysis
- Author
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MS Nefrologie, Circulatory Health, Assfalg, Volker, Miller, Gregor, Stocker, Felix, van Meel, Marieke, Groenevelt, Tiny, Tieken, Ineke, Ankerst, Donna, Renders, Lutz, Novotny, Alexander, Hartmann, Daniel, Jell, Alissa, Rahmel, Axel, Wahba, Roger, Muehlfeld, Anja, Antonia, Bouts, Ysebaert, Dirk, Globke, Brigitta, Jacobs-Tulleneers-Thevissen, Daniel, Piros, László, Stippel, Dirk, Heller, Katharina, Eisenberger, Ute, van Laecke, Steven, Weimer, Rolf, Rosenkranz, Alexander R, Berger, Stefan, Fischer, Lutz, Kliem, Volker, Vondran, Florian, Sester, Urban, Schneeberger, Stefan, Harth, Ana, Kuypers, Dirk, Függer, Reinhold, Arnol, Miha, Christiaans, Maarten, Weinmann-Menke, Julia, Krüger, Bernd, Hilbrands, Luuk, Banas, Bernhard, Hakenberg, Oliver, Minnee, Robert, Schwenger, Vedat, Heyne, Nils, van Zuilen, Arjan, Reindl-Schwaighofer, Roman, Lopau, Kai, Huüser, Norbert, Heemann, Uwe, MS Nefrologie, Circulatory Health, Assfalg, Volker, Miller, Gregor, Stocker, Felix, van Meel, Marieke, Groenevelt, Tiny, Tieken, Ineke, Ankerst, Donna, Renders, Lutz, Novotny, Alexander, Hartmann, Daniel, Jell, Alissa, Rahmel, Axel, Wahba, Roger, Muehlfeld, Anja, Antonia, Bouts, Ysebaert, Dirk, Globke, Brigitta, Jacobs-Tulleneers-Thevissen, Daniel, Piros, László, Stippel, Dirk, Heller, Katharina, Eisenberger, Ute, van Laecke, Steven, Weimer, Rolf, Rosenkranz, Alexander R, Berger, Stefan, Fischer, Lutz, Kliem, Volker, Vondran, Florian, Sester, Urban, Schneeberger, Stefan, Harth, Ana, Kuypers, Dirk, Függer, Reinhold, Arnol, Miha, Christiaans, Maarten, Weinmann-Menke, Julia, Krüger, Bernd, Hilbrands, Luuk, Banas, Bernhard, Hakenberg, Oliver, Minnee, Robert, Schwenger, Vedat, Heyne, Nils, van Zuilen, Arjan, Reindl-Schwaighofer, Roman, Lopau, Kai, Huüser, Norbert, and Heemann, Uwe
- Published
- 2022
6. The role of vascular smooth muscle Kv7 channels in renal perfusion
- Author
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Stocker, Felix
- Subjects
610 Medical sciences Medicine - Abstract
Vascular smooth muscle cell membranes contain potassium channels that by influencing membrane potential importantly contribute to the regulation of arterial tone. The KCNQ gene encodes for 5 different K+ channel subunits forming homo- or heteromeric Kv7, which are a family of voltage-dependent K+ channels functionally expressed in various vascular beds that can be activated by depolarizing stimuli and inactivated upon prolonged depolarization. In this thesis, the contribution of Kv7 to the regulation of renal arterial tone was studied, testing the hypotheses that (i) the Kv7.1-specific activator R-L3 is effective in causing reversible vasodilation of the entire renal arterial vasculature and that (ii) the endogenous vasodilators atrial natriuretic peptide (ANP) and Urocortin either attenuate or enhance the therapeutically intended vasodilatory effect of subunit-specific activation of Kv7.1 or Kv7.2-5 in small renal resistance arteries. Isometric wire myography was used to examine the contractile responses of short preglomerular resistance artery segments. A novel isolated perfused rat kidneys setup was introduced to investigate renal perfusion pressure as an indicator of arterial contractility on a whole-organ level. It was shown that pharmacological activation of Kv7.2-5 channels produces a strong anticontractile effect in agonist-induced vasoconstriction of renal resistance arteries. Specific activation of Kv7.1 was found to decrease sensitivity to vasoconstrictive agonists in small interlobar artery segments as well as to decrease perfusion pressure of intact perfused rat kidneys in a manner reversible by specific pharmacological Kv7.1 channel blockade. Unspecific blockade of all Kv7 was demonstrated to enhance arterial contractility in both isolated vessels and isolated perfused kidneys, whereas specific blockade of Kv7.1 was without either of these effects, indicating a contribution of homo- or heteromeric Kv7.4 and Kv7.5, but not homomeric Kv7.1, to resting tone of the renal arterial vasculature. Experiments on isolated interlobar vessels displayed dose-dependent vasorelaxations in response to the cGMP-coupled hormone ANP and the cAMP-dependent autocrine and paracrine vasodilator Urocortin in both agonist-induced and depolarization-induced vasoconstriction. Further experiments revealed that Kv7 contribute to vascular reactivity independently of the anticontractile effect induced by both ANP and Urocortin. The results presented here confirm our first hypothesis that R-L3 is effective in causing reversible vasorelaxation of the entire renal arterial bed, undermining a previously unappreciated role for Kv7.1 in regulating renal arterial contractility and renal perfusion pressure. By demonstrating the possibility to influence vascular tone through specific Kv7 modulators independently of both cGMP- and cAMP-dependent endogenous vasodilators and thus negating our second hypothesis, this thesis stresses the importance of Kv7 as potential therapeutic targets in the treatment of renovascular pathology.
- Published
- 2020
7. Coating of Intestinal Anastomoses for Prevention of Postoperative Leakage: A Systematic Review and Meta-Analysis.
- Author
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Cira K, Stocker F, Reischl S, Obermeier A, Friess H, Burgkart R, and Neumann PA
- Abstract
Background: For several decades, scientific efforts have been taken to develop strategies and medical aids for the reduction of anastomotic complications after intestinal surgery. Still, anastomotic leakage (AL) represents a frequently occurring postoperative complication with serious consequences on health, quality of life, and economic aspects. Approaches using collagen and/or fibrin-based sealants to cover intestinal anastomoses have shown promising effects toward leak reduction; however, they have not reached routine use yet. To assess the effects of covering intestinal anastomoses with collagen and/or fibrin-based sealants on postoperative leakage, a systematic review and meta-analysis were conducted., Method: PubMed, Web of Science, Cochrane Library, and Scopus (01/01/1964 to 17/01/2022) were searched to identify studies investigating the effects of coating any intestinal anastomoses with collagen and/or fibrin-based sealants on postoperative AL, reoperation rates, Clavien-Dindo major complication, mortality, and hospitalization length. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated., Results: Overall, 15 studies (five randomized controlled trials, three nonrandomized intervention studies, six observational cohort studies) examining 1,387 patients in the intervention group and 2,243 in the control group were included. Using fixed-effects meta-analysis ( I
2 < 50%), patients with coated intestinal anastomoses presented significantly lower AL rates (OR = 0.37; 95% CI 0.27-0.52; p < 0.00001), reoperation rates (OR, 0.21; 95% CI, 0.10-0.47; p = 0.0001), and Clavien-Dindo major complication rates (OR, 0.54; 95% CI, 0.35-0.84; p = 0.006) in comparison to controls, with results remaining stable in sensitivity and subgroup analyses (stratified by study design, age group, intervention used, location of anastomoses, and indication for surgery). The length of hospitalization was significantly shorter in the intervention group (weighted mean difference (WMD), -1.96; 95% CI, -3.21, -0.71; p = 0.002) using random-effects meta-analysis ( I2 ≥ 50%), especially for patients with surgery of upper gastrointestinal malignancy (WMD, -4.94; 95% CI, -7.98, -1.90; p = 0.001)., Conclusion: The application of collagen-based laminar biomaterials or fibrin sealants on intestinal anastomoses can significantly reduce postoperative rates of AL and its sequelae. Coating of intestinal anastomoses could be a step toward effective and sustainable leak prevention. To assess the validity and robustness of these findings, further clinical studies need to be conducted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Cira, Stocker, Reischl, Obermeier, Friess, Burgkart and Neumann.)- Published
- 2022
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