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Background: Living donor liver transplantation (LDLT) is an option to expand the donor organ pool for patients with life-threatening diseases who cannot be supplied with a cadaver organ. Next to the donor risks, complications after ABO-incompatible LDLT (ABOi LDLT) in the recipient are subject to controversial discussion. Improvement in ABOi graft survival rates have been achieved with plasma treatment procedures (PTP) and immunosuppression but antibody-mediated rejection (AMR) and graft loss still occur. Methods: Since 2008, we have prepared 10 patients for ABOi LDLT. Seven of the 10 patients for transplantation had hepatocellular carcinoma (HCC). Results: All patients underwent PTP before and after ABOi LDLT as well as immunosuppression according to the treatment schedule. We did not use anti-CD20 monoclonal antibodies in the transplant setting. We transplanted 6 of 10 preconditioned patients. After 3 years, 5 of the 6 transplanted patients were still alive. Conclusion: Even if B-cell depletion with anti-CD 20 treatment in the setting of ABOi LDLT is commonly accepted, our center successfully administered only quadruple drug immunosuppression combined with PTP. Especially patients with HCC had a high titer increment also pre-transplantation and were at high risk for arterial thrombosis and graft loss.

Alljährlich zeichnen die Herausgeber und die Thieme-Gruppe mit dem HaMiPla Best-Paper-Award die Top Publikationen in Handchirurgie und Plastischer Chirurgie aus, die unsere Leser und Nutzer im vergangenen Jahr am meisten interessiert haben. Gemessen wird dies anhand der online-Zugriffstatistiken auf die im jeweiligen Jahr veröffentlichten Artikel.

Silke Rummler,1 Sabine Volkholz,1 Thomas Steinke,2 Katrin Maier,1 Heike Jütte,1 Agnieszka Hilge,1 Patrice Ziehm1 1Institute of Transfusion Medicine, 2Department of Cardiothoracic Surgery, University Hospital Jena, Jena, Germany Abstract: Performing clinical procedures and optimal management of Spectra Optia in combination with secondary plasma devices (SPDs) have not been described in the literature. To contribute to this topic, we examined 300 data log files from patients treated with the Spectra Optia from November 2015 until October 2016. Of these 300 procedures, 149 secondary plasma treatments were conducted in 13 patients (76 immunoadsorption [IA] and 73 lipoprotein apheresis [LA]). Nine patients had IA due to transplantation and autoimmune diseases. Four patients were treated with LA after heart transplantation. Of the procedures, 62% were performed using peripheral venous access, even in patients with a low inlet blood flow. A central catheter was required only in 15% cases, and an arteriovenous fistula in 23% of the procedures. Anticoagulation management differed in both procedures. The LA procedures required a higher amount of citrate as they were performed using only citrate. The IA procedures required less citrate because a mixture of citrate and heparin was used. We did not observe clotting or bleeding, regardless of heparin use. Due to strict calcium management, no patient showed signs of hypocalcemia. Despite our apheresis management, four procedures had to be canceled preliminarily due to patient complications. The targeted substances could be reduced significantly: lipoprotein (a) (Lpa) level by 68% (76%–45%), low-density lipoprotein-cholesterol by 57% (64%–37%), and IgG from 6.6 (1.09–21.0) to 2.61 (0.33–14.7) g/l. The Cobe could be replaced by the Optia system effectively. The Optia has a high plasma extraction efficiency, which allows SPD procedures with peripheral venous access and moderate inlet flow rates. Keywords: adverse events, anticoagulation, peripher venous access, lipoprotein apheresis, immunoadsorption

The authors focus on strategies and aesthetics of urban expansion in Lagos and London by members of the Redeemed Christian Church of God. On the one hand, these two metropolises represent very different forms of urban governance and religious context. On the other, they are juxtaposed and conjoined in significant ways as believers seek to fulfill spiritual and economic aspirations. ‘London-Lagos’ becomes a stretched city space that is created but also traversed as members negotiate diasporic linkages in the remaking of their lives as both believers and urban citizens.

For a long time, it was considered medical malpractice to neglect the blood group system during transplantation. Because there are far more patients waiting for organs than organs available, a variety of attempts have been made to transplant AB0-incompatible (AB0i) grafts. Improvements in AB0i graft survival rates have been achieved with immunosuppression regimens and plasma treatment procedures. Nevertheless, some grafts are rejected early after AB0i living donor liver transplantation (LDLT) due to antibody mediated rejection or later biliary complications that affect the quality of life. Therefore, the AB0i LDLT is an option only for emergency situations, and it requires careful planning. This review compares the treatment possibilities and their effect on the patients' graft outcome from 2010 to the present. We compared 11 transplant center regimens and their outcomes. The best improvement, next to plasma treatment procedures, has been reached with the prophylactic use of rituximab more than one week before AB0i LDLT. Unfortunately, no standardized treatment protocols are available. Each center treats its patients with its own scheme. Nevertheless, the transplant results are homogeneous. Due to refined treatment strategies, AB0i LDLT is a feasible option today and almost free of severe complications.

We explore the tensions evident among Nigerian Pentecostals in London between social and ideological insularity on the one hand, and a more outward-oriented, expansive orientation on the other. Analysis of these stances is complemented by the exploration of believers' actions within a material but also metaphorical arena that we term “London-Lagos.” Such themes are developed specifically through a focus on believers' relations with Nigerian and British state systems in relation to child-rearing—an activity that renders parents sometimes dangerously visible to apparatuses of the state but also raises key dilemmas concerning the proper and moral location of socialisation into Christian values. We show how such dilemmas are embodied in a play, written by a Nigerian Pentecostalist, termed “The Vine-Keepers.”

The following interview with Dr. Yves Bergevin on the consequences of maternal morbidity and mortality in developing countries was conducted in November 2007. Dr. Bergevin, MD, MSc, FRCPC, FCFP, is Senior Program Advisor for Reproductive Health at the United Nations Population Fund's (UNFPA) Africa Division. He provides the overall program leadership for reproductive health programs in Africa for UNFPA, including HIV Prevention, Maternal Health, Family Planning, and Reproductive Health Commodity Security. Dr. Bergevin has held several senior level positions in global health, including Chief of Health at UNICEF, where he fostered a renewed focus on child survival. Prior to this, he was Principal Advisor for Health, Population, and Nutrition at the Canadian International Development Agency (CIDA). He is the author of over 100 papers, abstracts, and reports. He has also served as a Member of the Board on Global Health, National Academies of Sciences (USA), a Member of the STOP TB Coordinating Board and of th...

Der Beitrag befasst sich mit dem Jugendbeirat der Nachhaltigkeitsstrategie Baden-Wurttemberg, der 2012 als Schnittstelle zwischen der jungen Generation und dem politischen System institutionalisiert wurde. Nach einer allgemeinen Einfuhrung wird ein Uberblick uber die Situation der (politisch) institutionalisierten Jugendbeteiligung in anderen Bundeslandern gegeben. Da sich der Jugendbeirat hauptsachlich mit Themen der Nachhaltigen Entwicklung beschaftigt, erfolgt eine theoretische Einordung des Begriffs „Nachhaltigkeit“ im Hinblick auf dessen Ausgestaltung in der praktischen Arbeit des Jugendbeirats sowie in der politischen Jugendbeteiligung im Allgemeinen. Abschliesend werden aus den Erfahrungen der Beiratsarbeit mogliche Erfolgsfaktoren fur andere Jugendbeteiligungsprozesse abgeleitet.