Fabian Rössler

• Doctor of Medicine
• Consultant Transplant Surgeon at Department of Surgery and Transplantation - University of Zurich

Background: Simultaneous pancreas and kidney transplantation (SPK) remains the only curative treatment for type I diabetics with end-stage kidney disease. SPK using donors after circulatory death (DCD) is one important measure to expand the organ pool for pancreas transplantation (PT). After initial doubts due to higher complications, DCD SPK is no...

Importance Surgical site infections (SSIs) are one of the most common health care–associated infections. Surgical site infections can have harmful effects in liver transplant (LT) recipients. Objective To assess the incidence of SSI after LT and identify risk factors associated with SSIs and whether SSIs are associated with death and graft loss....

Background Biopsy-based transcripts associated with antibody-mediated rejection (AMR) hold promise as substitutes for C4d positivity. However, their utility in cases with additional diagnoses other than rejection remains inadequately studied. Methods In our comprehensive analysis of 326 kidney allograft biopsies, assessed by histology and the Mole...

Background Donor-derived cell-free DNA (dd-cfDNA) is a promising non-invasive biomarker for detecting graft injury in solid organ transplant recipients. Elevated dd-cfDNA levels are strongly associated with rejection and graft injury, especially antibody-mediated rejection (ABMR). While de novo donor-specific antibodies (dnDSA) are crucial in ABMR,...

The molecular HLA epitope mismatch is an advanced measure for developing de novo donor-specific antibodies (dnDSA) after kidney transplantation. Its relevance in simultaneous pancreas/kidney transplant recipients (SPKTRs) remains unclear. We investigated dnDSA development in 72 SPKTRs and 383 kidney transplant recipients (KTRs) and used the Predict...

Background/Objectives: ABO-incompatible live-donor kidney transplantation (ABOi-LDKT) has become an established treatment for end-stage renal disease. Non-inferiority in the long-term graft function compared to ABO-compatible live-donor kidney transplantations (ABOc-LDKTs) has been shown. However, the assumed burden due to complications owing to in...

The surgical repair of giant inguinal hernias with loss of domain, defined as the relocation of the majority of the intestine into the hernia sac, poses a significant challenge. In the majority of cases, a combination of different surgical techniques with the placement of multiple meshes is necessary to achieve reduction of such complex hernias. Th...

Simultaneous pancreas and kidney transplantation (SPK) represents the most effective treatment for selected patients with type 1 diabetes and end-stage kidney disease. However, SPK is a technically complex surgical procedure and is particularly challenging in patients with anatomical variations. Situs inversus abdominalis (SIA) is a rare hereditary...

Introduction Most of Switzerland’s population and employment opportunities are concentrated in urban areas. Although kidney transplantation (KT) is the preferred therapy for eligible candidates, individuals in rural areas face challenges accessing specialized medical services due to longer travel distances. Limited understanding exists regarding pa...

Background Since 1998, the Swiss Organ Living-Donor Health Registry (SOL-DHR) has recorded peri- and postoperative complications of living kidney (LK) donors, as reported by all Swiss transplant centers and has collected follow-up data prospectively. Methods We analyzed the early complications of 2379 consecutive individuals who donated a kidney b...

Purpose The Barcelona Clinic Liver Cancer (BCLC) staging schema is widely used for hepatocellular carcinoma (HCC) treatment. In the updated recommendations, HCC BCLC stage B can become candidates for transplantation. In contrast, hepatectomy is currently not recommended. Methods This systematic review includes a multi-institutional meta-analysis o...

Diabetes mellitus (DM) is a significant risk factor for peripheral arterial disease (PAD), and PAD is an independent predictor of cardiovascular disorders (CVDs). Growing evidence suggests that long non-coding RNAs (lncRNAs) significantly contribute to disease development and underlying complications, particularly affecting smooth muscle cells (SMC...

Objective Evaluation of the benefits of a virtual reality (VR) environment with a head-mounted display (HMD) for decision-making in liver surgery. Background Training in liver surgery involves appraising radiologic images and considering the patient’s clinical information. Accurate assessment of 2D-tomography images is complex and requires conside...

Background Enterobacterales are often responsible for urinary tract infection (UTI) in kidney transplant recipients. Among these, Escherichia coli or Klebsiella species producing extended-spectrum beta-lactamase (ESBL) are emerging. However, there are only scarce data on frequency and impact of ESBL-UTI on transplant outcomes. Methods We investiga...

Diabetes mellitus (DM) is a significant risk factor for peripheral arterial disease (PAD), and PAD is an independent predictor of cardiovascular disorders (CVDs). Growing evidence suggests that long non-coding RNAs (lncRNAs) significantly contribute to disease development and underlying complications, particularly affecting smooth muscle cells (SMC...

Simple Summary Robotic kidney cancer surgery is commonly performed by two different approaches: the transperitoneal approach (TP) and the retroperitoneal approach (RP). Both methods have challenges, such as limited space (RP) or difficulties in dissecting the renal artery (TP). A combination of both methods, called a hybrid approach, has been descr...

Background and Aims Obesity is a growing healthcare challenge worldwide and a significant risk factor for liver failure as seen with non‐alcoholic steatohepatitis (NASH). Combining metabolic‐bariatric surgery (MBS) with liver transplantation (LT) appears as attractive strategy to treat both, the underlying liver disease and obesity. However, there...

Background Groove pancreatitis is a focal form of chronic pancreatitis affecting the area of the paraduodenal groove. The aim of this systematic review was to assess the clinical presentation, diagnosis and treatment of patients with groove pancreatitis. Methods Medical literature databases (Embase, Medline via PubMed and Cochrane Central Register...

Background The heterogeneous quality of studies on arteriovenous fistulas outcome, with variable clinical settings and large variations in definitions of patency and failure rates, leads to frequent misinterpretations and overestimation of arteriovenous fistula patency. Hence, this study aimed to provide realistic and clinically relevant long‐term...

Proper biobanking is essential for obtaining reliable data, particularly for next-generation sequencing approaches. Diseased vascular tissues, having extended atherosclerotic pathologies, represent a particular challenge due to low RNA quality. In order to address this issue, we isolated RNA from vascular samples collected in our Swiss Vascular Bio...

Purpose To assess the predictive value of intraoperative indocyanine green (ICG) test in patients undergoing staged hepatectomy. Methods We analyzed intraoperative ICG measurements of future liver remnant (FLR), preoperative ICG, volumetry, and hepatobiliary scintigraphy in 15 patients undergoing associated liver partition and portal vein ligation...

Ectopic peritransplant varicosis represents an uncommon cause of late-onset gastrointestinal (GI) bleeding after simultaneous pancreas and kidney transplantation (SPK). We report on a 53-year-old female patient who suffered from recurrent upper GI bleeding seven years after SPK with persistent graft function. Upper endoscopy revealed perianastomoti...

Background AB0 incompatible kidney transplantation has become a genuine treatment for end-stage renal disease. Non-inferiority in long term graft function compared to AB0 compatible transplantation has been shown. However, the assumed burden due to complications owing to increased immunosuppression inherent to AB0 incompatible transplantation has n...

Background: Despite great progress in graft survival and complication rates, pronounced inflammatory responses are common after pancreas transplantation (PT). Subsequent to the first postoperative increase in inflammatory markers, we have frequently observed a second peak of C-reactive protein (CRP) and white blood cells (WBCs) following PT. This a...

Surgery plays a central role in the treatment of benign and malignant pancreatic diseases. Artificial intelligence (AI) is an important upcoming technology to support surgeons in pre-, intra-, and postoperative diagnosis, decision-making and training toward an optimized patient care. Current AI applications show a promising role in the evaluation o...

This case describes a rare presentation of a diffuse large B-cell lymphoma not otherwise specified (DLBC NOS) in the gallbladder. We report the case of an 89-year-old male who initially presented with a two-week history of weakness and abdominal discomfort. We performed laparoscopic cholecystectomy for suspicion of acute cholecystitis. After the in...

Background: Pancreatic cancer often presents as locally advanced (LAPC) or borderline resectable (BRPC). Neoadjuvant systemic therapy is recommended as initial treatment. It is currently unclear what chemotherapy should be preferred for patients with BRPC or LAPC. Methods: We performed a systematic review and multi-institutional meta-analysis of...

Introduction Compression syndromes of the celiac artery (CAS) or superior mesenteric artery (SMAS) are rare conditions that are difficult to diagnose; optimal treatment remains complex, and symptoms often persist after surgery. We aim to review the literature on surgical treatment and postoperative outcome in CAS and SMAS syndrome. Methods A syste...

We aimed to assess the effect of donor pancreas extraction time (ET) on postoperative complications and graft function after pancreas transplantation (PT). We analyzed all consecutive donor pancreas procurements for the simultaneous pancreas and kidney transplantation (SPK) and the associated PT in a Swiss transplant center over a 20-year period. P...

Background: Benchmark comparisons in surgery allow identification of gaps in the quality of care provided. The aim of this study was to determine quality thresholds for high (HAR) and low (LAR) anterior resections in colorectal cancer surgery by applying the concept of benchmarking. Methods: This 5-year multinational retrospective study included...

Zusammenfassung Hintergrund Die Pankreastransplantation ist die erste Wahl in der Behandlung von Patienten mit schwer einstellbarem, insulinabhängigem Diabetes mellitus. Die häufigste Form ist die simultane Pankreas- und Nierentransplantation bei Menschen mit insulinabhängigem Diabetes mellitus und einer kombiniert eingeschränkten Nierenfunktion....

Background: There is an increasing demand for kidney retransplantation. Most studies report inferior outcomes compared to primary transplantation, consequently feeding an ethical dilemma in the context of chronic organ shortage. Objective: To assess variables influencing long-term graft survival after kidney retransplantation. Material and Metho...

The arterial baroreflex is a key autonomic regulator of blood pressure whose dysfunction has been related to several cardiovascular diseases. Changes in blood pressure are sensed by specific mechanosensory proteins, called baroreceptors, particularly located in the outer layer of the carotid sinus and the inner curvature of the aortic arch. The sig...

Venous Allograft Thrombosis (VAT) is the leading non-immunological cause for early graft loss after kidney transplantation (KT), with a reported prevalence up to 4.2% [1]. VAT usually has a devastating effect, notoriously difficult to treat and ultimately leading to graft loss in most cases. In contrast, post-transplant lymphocele is a frequent com...

The natural connection between the duodenum and the pancreatic duct enables a minimally invasive access to the pancreas. Endoscopically this access is already regularly used, mainly for diagnostic and even for certain therapeutic purposes. With per-oral pancreatoscopy the endopancreatic approach allows the direct visualization of the pancreatic duc...

Hepatocellular carcinoma (HCC) can have viral or non-viral causes 1–5 . Non-alcoholic steatohepatitis (NASH) is an important driver of HCC. Immunotherapy has been approved for treating HCC, but biomarker-based stratification of patients for optimal response to therapy is an unmet need 6,7 . Here we report the progressive accumulation of exhausted,...

Background Obesity adversely affects waitlisting and precludes patients with concomitant end‐stage renal disease and type 1 diabetes mellitus from getting a simultaneous pancreas and kidney transplantation (SPK). Objective To analyze safety and efficacy of laparoscopic sleeve gastrectomy (LSG) before SPK in severely obese type I diabetics. Method...

Objective. To assess outcome and safety of 571 hybrid natural orifice transluminal endoscopic surgery (NOTES) cholecystectomies. Methods. We retrospectively analyzed all consecutive NOTES cholecystectomies performed at our center between June 2009 and January 2018. All procedures were performed using a hybrid transvaginal technique, including an um...

Reliable determination of Ki67 labeling index (Ki67-LI) on core needle biopsy (CNB) is essential for determining breast cancer molecular subtype for therapy planning. However, studies on agreement between molecular subtype and Ki67-LI between CNB and surgical resection (SR) specimens are conflicting. The present study analyzed the influence of clin...

Objective: To measure and define the best achievable outcome after major hepatectomy. Background: No reference values are available on outcomes after major hepatectomies. Analysis in living liver donors, with safety as the highest priority, offers the opportunity to define outcome benchmarks as the best possible results. Methods: Outcome analy...

Reliable determination of Ki67 labeling index (Ki67 LI) on core needle biopsy specimens (CNB) is essential for determining breast cancer intrinsic subtype (IST), preoperative treatment decisions and short-term treatment response during neoadjuvant therapy. However, analyses investigating robustness of Ki67 LI assessment upon repeated tumor biopsies...

The receptor activator of NF-κB (RANK) signalling pathway represents a promising target for the therapy of bone-related tumours. In the present study we evaluated the impact of the expression of RANK and its ligand (RANKL) on survival and response to chemotherapy in osteosarcoma patients.Expression of RANK and RANKL was examined in 91 human osteosa...

Background: The mesenchymal–epithelial transition (MET) pathway is frequently altered in tumours. The purpose of our study was to determine the prognostic value of tumour MET expression levels in patients with triple-negative breast cancer (TNBC), in order to strengthen the rationale for targeted therapy of TNBC using MET inhibitors. Methods: We d...