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The Clinic of Hepatobiliary and Transplant Surgery offers interdisciplinary treatment of tumours of the liver, biliary tract and gall bladder and liver, kidney and pancreas transplants.
Universitätsklinikum Hamburg-Eppendorf (UKE)
University Medical Centre, Hamburg, Germany
Clinic of Hepatobiliary and Transplant Surgery
Prof Nashan is Professor of Surgery and leads the Clinic of Hepatobiliary and Transplant Surgery at UKE Hamburg.
Prof Björn Nashan
Patients and families are supported with translation service, airport shuttle, driver service and many other services provided by the International Office of the UKE.
This work is done on an interdisciplinary level including specialists from hepatology, oncology and radiology.
Benign liver tumours and gall bladder tumours
One focus of treatment is the advancement of minimally invasive therapy for benign liver tumours and tumours of the gall bladder.
Within the framework of the University Cancer Centre Hamburg (UCCH), UKE has established interdisciplinary special consultation for patients with liver and biliary tract tumours.
Focus areas of research include transplantation immunology, immunogenetics, tissue engineering, fundamental oncological research (cancer of the liver and biliary tract, metastases in the liver), immunosuppression in organ transplants, developing 3D-guided navigation procedures for liver resection and clinical trials for the treatment of patients with liver metastases.
UKE established Europe’s first living donor liver donation programme and is the largest pediatric liver transplant centre in Europe, conducting 20 paediatric liver transplants per year
Pioneering Transplant Department
The aim of the UKE Transplant Centre is to provide interdisciplinary clinical and scientific support to all transplant recipients and organ donors.
Transplant psychologists offer support to all kidney recipients and donors.
Patients with high immunologic risk
One of the focus areas of the clinic is transplantation in patients with high immunologic risk.
For international patients who are not members of the Eurotransplant zone (Germany, Belgium, the Netherlands, Austria, Luxembourg, Croatia, Slovenia), UKE can only offer living donor transplants - i.e. a suitable organ donor from the patient’s family must be brought along, who will donate part of his/her liver.
In adult recipients this is usually the right liver lobe, while for paediatric recipients liver segments II and III are usually sufficient.
UKE has an extensive and active liver transplant program, with more than 1,700 liver transplantations performed between 1990 and 2009 (approximately 1,100 in adults and 600 in children).
Selection of liver patients and donors
Recipients who are accepted as patients after sending their medical documents may travel to Hamburg for further evaluation.
Living donors who are accepted after sending the pre-evaluation form should arrive in Hamburg as outpatients. Additional examinations will be carried out, taking into account the individual needs of the donor.
Living donors must be a relative of the recipient, between 18-60 years old, with no obesity or previous deep vein thrombosis or pulmonary embolism.
After a liver transplant, the recipient usually remains hospitalised for 4-6 weeks. Discharge is followed by an outpatient aftercare period of at least 4-6 weeks to allow the body to adjust to the new drugs that suppress the immune system and prevent rejection of the liver.
After a living donation, the donor remains hospitalised for approximately 7-14 days. Subsequently he is treated in the outpatient clinic and after 4-6 weeks travels back to his home country.
UKE performs more than 100 kidney transplants per year, for both adults and children.
Selection of kidney patients and donors
Common causes of terminal renal insufficiency are diabetes mellitus, hypertension (high blood pressure), glomerulonephritis, interstitial nephritis and polycystic kidney degeneration.
A kidney transplant must always be considered if a patient requires dialysis, because compared with dialysis it leads to better survival rates and much better quality of life.
International patients who are not resident in the Eurotransplant zone (see above) will not receive a cadaver kidney transplant via Eurotransplant and must bring a matching living donor.
Almost all patients with severe kidney problems, including dialysis patients, stand to benefit from a transplant. There is no absolute age limit.
It is important that diseases which could endanger the patient during or after transplantation are excluded, during a detailed preliminary examination.
For a living kidney donation, donor and recipient need not have the same blood type. However close attention must be paid to histocompatibility, particularly with patients who have received a transplant before.
For the donor there is no age limit. The donor must be healthy and free of major risk factors for future kidney disease (e.g., diabetes). After a living donation, the donor remains hospitalised for approximately 7 days.
After a kidney transplant, the recipient usually remains hospitalised for 7-14 days. Discharge is followed by an outpatient aftercare period of at least 4-6 weeks.
UKE also offers combined kidney/pancreas and liver/kidney transplants.
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It is led by Prof Björn Nashan and is the largest transplant centre in Northern Germany, with nearly 200 transplants performed.
The main part of his clinical work is devoted to extended liver surgery in patients with primary and secondary lesions of the liver, as well as malignancies of the bile duct, i.e. cholangiocarcinoma and Klatzkin tumours.
He is also Professor of Microbiology and Immunology, Dalhousie University, Halifax, Canada.
These are complex tumours to treat, requiring innovative therapeutic approaches, including 3D reconstruction and navigation.
Patients are assessed with the help of many specialists at a single appointment.
It performs transplants on adults and children and almost all German scientific clinical publications on liver transplantation in children stem from UKE.
Patients are cared for jointly by the transplant surgery, nephrology and paediatric nephrology departments.
Lliving donor organs across blood groups (ABO incompatible transplants).
This includes transplantation of:
Highly sensitised recipients (desensitisation programme).
Since the liver has the ability to regenerate quickly, the donated part of the liver will grow back within a few weeks.
Normally, the evaluation phase takes about 2 weeks, during which it is decided whether the donor is really a good match. If so, a surgery date can be fixed.
Obtaining a kidney transplant is the only curative treatment option for end-stage renal insufficiency.
These include particularly severe untreated infections, uncured tumours and severe heart, vascular, and pulmonary diseases.
This allows the body to adjust to the new drugs that suppress the immune system and prevent rejection of the kidney.