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Karl Herbert Hillebrandt

Karl Herbert Hillebrandt

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61
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460
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Publications

Publications (61)
Article
Full-text available
Even in most complex surgical settings, recent advances in minimal-invasive technologies have made the application of robotic-assisted devices more viable. Due to ever increasing experience and expertise, many large international centers now offer robotic-assisted pancreatic surgery as a preferred alternative. In general however, pancreatic operati...
Article
Full-text available
Background Due to the COVID-19 pandemic, an extensive reorganisation of healthcare resources was necessary—with a particular impact on surgical care across all disciplines. However, the direct and indirect consequences of this redistribution of resources on surgical therapy and care are largely unknown. Methods We analysed our prospectively collec...
Article
Journal Name: Biomaterials advances - ISSN: 2772-9508 Keywords: Decellularization, Decellularized pancreas , MR elastography, Solid fraction, Viscoelastic models The role of extracellular matrix (ECM) composition and turnover in mechano-signaling and the metamorphic fate of cells seeded into decellularized tissue can be elucidated by recent dev...
Conference Paper
*Purpose: We aimed to characterize the performance of old vs. young liver grafts in a standardized rat model of normothermic ex vivo liver machine perfusion (NEVLP), as liver grafts are frequently declined due to high donor age or age mismatch with the recipient. *Methods: Livers from Sprague Dawley rats aged 3 months or 12 months were harvested a...
Article
Full-text available
Background: Obesity in the recipient is linked to inferior transplant outcome. Consequently, access to kidney transplantation (KT) is often restricted by body mass index (BMI) thresholds. Bariatric surgery (BS) has been established as a superior treatment for obesity compared to conservative measures, but it is unclear whether it is beneficial for...
Article
Full-text available
(1) Background: Perineural invasion (PNI) is a common characteristic of pancreatic ductal adenocarcinoma (PDAC) and is present in most resection margins. We hypothesized that curative pancreatic tumor resection with long-term survival could only be achieved in PNI-negative patients. (2) Material and Methods: A retrospective investigation of PDAC pa...
Article
Full-text available
Diaphragmatic impairments exhibit high morbidity as well as mortality while current treatment options remain unsatisfactory. Tissue engineering (TE) approaches have explored the generation of an optimal biocompatible scaffold for diaphragmatic repair through tissue decellularization or de novo construction, with or without the addition of cells. We...
Preprint
Three-dimensionally (3D) printed tissue mimics are a unique in vitro platform for studying human pathophysiology in a more physiologically relevant manner compared to oversimplified 2D cell cultures and complex animal models. Furthermore, they can be used for replacing parts of damaged tissue or organs. However, their 3D printing requires an availa...
Article
Full-text available
Background Robotic pancreatic surgery (RPS) is associated with high intraoperative costs compared to open pancreatic surgery (OPS). However, it remains unclear whether several advantages of RPS such as reduced surgical trauma and a shorter postoperative recovery time could lead to a reduction in total costs outweighing the intraoperative costs. The...
Article
Full-text available
Purpose Artificial organs might serve as alternative solutions for whole organ transplantation. Decellularization of a liver provides a non-immunogenic matrix with the advantage of three afferent systems, the portal vein, the hepatic artery and the bile duct. This study aims to evaluate the recellularization of rat livers with islets of Langerhans...
Article
Full-text available
Background Robotic-assisted pancreatic surgery is limited to specialized high-volume centers and selected patient cohorts. Especially for patients with a history of previous abdominal surgeries, the standard procedure remains open surgery due to the fear of complications caused by abdominal adhesions. Methods Clinical data of all consecutive patie...
Article
Background, objectives: In recent years, ERAS treatment pathways have found their way into many surgical fields, as they reduce complications and accelerate postoperative recovery. For thoracic surgery, the first ERAS guidelines were published by the ERAS Society and the European Society of Thoracic Surgeons (ESTS) in 2019. We have now evaluated h...
Article
Zusammenfassung Die roboterassistierte Chirurgie hat sich in den letzten Jahren deutlich weiterentwickelt und wurde in immer mehr Teilbereichen der Chirurgie als fester Bestandteil des operativen Spektrums implementiert. Dieser Beitrag legt den aktuellen Stand der roboterassistierten Chirurgie in Bereichen der Allgemein-, Viszeral- und Thoraxchirur...
Article
Full-text available
Background: Minimally invasive liver surgery (MILS) has a high variance in the type of resection and complexity, which has been underestimated in learning curve studies in the past. The aim of this work was to evaluate complexity-adjusted learning curves over time for laparoscopic liver resection (LLR) and robotic liver resection (RLR). Methods: C...
Article
Full-text available
Introduction Establishing a sufficient pancreatico-enteric anastomosis remains one of the most important challenges in open single stage pancreatoduodenectomy as they are associated with persisting morbidity and mortality. Applicability on a robotic-assisted approach, however, even increases the requirements. With this analysis we introduce a dorsa...
Article
Full-text available
Background Robotic-assisted pancreatic surgery (RPS) has fundamentally developed over the past few years. For subgroups, e.g. elderly patients, applicability and safety of RPS still needs to be defined. Given prognosticated demographic developments, we aim to assess the role of RPS based on preoperative, operative and postoperative parameters. Met...
Article
Full-text available
Background Since autologous veins are unavailable when needed in more than 20% of cases in vascular surgery, the production of personalized biological vascular grafts for implantation has become crucial. Surface modification of decellularized xenogeneic grafts with vascular cells to achieve physiological luminal coverage and eventually thromboresis...
Article
Full-text available
Introduction: In pediatric liver transplantation (pLT), hepatic artery thrombosis (HAT) is associated with inferior transplant outcome. Hepatic artery reconstruction (HAR) using an operating microscope (OM) is considered to reduce the incidence of HAT. Methods: HAR using an OM was compared to a historic cohort using surgical loupes (SL) in pLT p...
Article
Background and objective: Due to the coronavirus disease 2019 (COVID-19) pandemic extensive reorganization and limitation of resources within the healthcare system became inevitable. This review highlights the direct and indirect impact of the COVID-19 pandemic on the fields of hepato-pancreato-biliary (HPB) surgery and organ transplantation incor...
Article
Full-text available
The COVID-19 pandemic challenges international and national healthcare systems. In the field of thoracic surgery, procedures may be deferred due to mandatory constraints of the access to diagnostics, staff and follow-up facilities. There is a lack of prospective data on the management of benign and malignant thoracic conditions in the pandemic. The...
Article
Full-text available
Acute cellular rejection (ACR) after liver transplantation (LT) goes along with allograft dysfunction, which is diagnosed by liver biopsy and concomitant histological analysis, representing the gold standard in clinical practice. Yet, liver biopsies are invasive, costly, time-intensive and require expert knowledge. Herein we present substantial evi...
Article
Full-text available
Background Many patients suffering from peripheral arterial disease (PAD) are dependent on bypass surgery. However, in some patients no suitable replacements (i.e. autologous or prosthetic bypass grafts) are available. Advances have been made to develop autologous tissue engineered vascular grafts (TEVG) using endothelial colony forming cells (ECFC...
Article
Background/Aims: Long-term survival of liver transplant recipients is endangered by tumorigenesis at different sites. Little is known about primary de novo tumors developing in the graft. Methods: We analyzed the follow-up data of 2731 liver recipients that were transplanted between 1988 and 2019 at our institution (Charité – Universitätsmedizin Be...
Article
Islet-based recellularization of decellularized, repurposed rat livers may form a transplantable Neo-Pancreas. The aim of this study is the establishment of the necessary protocols, the evaluation of the organ structure and the analysis of the islet functionality ex vivo. After perfusion-based decellularization of rat livers, matrices were repopula...
Article
Zusammenfassung Hintergrund Die Thoraxchirurgie ist im Alltag durch die COVID-19-Pandemie mit neuen Herausforderungen konfrontiert. Gegenwärtig werden unterschiedliche Konzepte und Empfehlungen verfolgt, um unsere Patienten/-innen und uns selbst zu schützen. Wie diese im Einzelnen umgesetzt werden, kann jedoch aufgrund der bestehenden Infrastruktur...
Article
The production of biomaterials that endow significant morphogenic and microenvironmental cues for the constitution of cell integration and regeneration remains a key challenge in the successful implementation of functional organ replacements. Despite the vast development in the production of biological and architecturally native matrices, the compl...
Article
Full-text available
The ongoing SARS‐CoV‐2 pandemic has a drastic impact on national healthcare systems. Given the overwhelming demand of facility capacity, the impact on all healthcare sectors has to be addressed. Solid organ transplantation represents a field with a high demand on staff, intensive care units and follow‐up facilities. The great therapeutic value of o...
Article
Maintenance of tissue extracellular matrix (ECM) and its biomechanical properties for tissue engineering is one of the substantial challenges in the field of decellularization and recellularization. Preservation of the organ-specific biomatrix is crucial for successful recellularization to support cell survival, proliferation, and functionality. Ho...
Article
Full-text available
Hepatocyte transplantation (HcTx) is a promising approach for the treatment of metabolic diseases in newborns and children. The most common application route is the portal vein, which is difficult to access in the newborn. Transfemoral access to the splenic artery for HcTx has been evaluated in adults, with trials suggesting hepatocyte translocatio...
Chapter
The severe short- and long-term unwanted effects and the huge economic burden of diabetes mellitus have led to immense research efforts regarding possible therapeutic modalities. Subcutaneous insulin injection and external insulin pumps, the so-called open-loop methods, albeit already established in clinical practice, are unable to maintain long-te...
Article
Impact statement: Ex vivo liver machine perfusion (MP) is an emerging preservation alternative to static cold storage. Even though clinical studies have shown benefits for extended criteria donor grafts, standardized systems for perfusion of rat liver grafts are not available, which are inevitable for large-scaled studies on liver reconditioning b...
Article
Three‐dimensional tissue cultures are important models for the study of cell‐cell and cell‐matrix interactions, as well as, to investigate tissue repair and reconstruction pathways. Therefore, we designed a reproducible and easy to handle printable bioreactor system (Teburu), that is applicable for different approaches of pathway investigation and...
Article
Transplantation is the only curative treatment option available for patients suffering from end‐stage organ failure, improving their quality of life and long‐term survival. However, due to organ scarcity, only a small number of these patients actually benefit from transplantation. Alternative treatment options are needed to address this problem. Th...
Article
Full-text available
Research and therapeutic applications create a high demand for primary human hepatocytes. The limiting factor for their utilization is the availability of metabolically active hepatocytes in large quantities. Centrifugation through Percoll, which is commonly performed during hepatocyte isolation, has so far not been systematically evaluated in the...
Chapter
Liver transplantation continues to be the gold standard for the treatment of patients with acute liver failure, chronic liver diseases, and in the early stages of hepatocellular carcinoma. However, the success of liver transplantation is increasingly limited by the lack of suitable donor organs. Liver support systems have been developed in order to...
Article
Introduction: Labeling using iron oxide particles enables cell tracking via magnetic resonance imaging (MRI). However, the magnetic field can affect the particle-labeled cells. Here, we investigated the effects of a clinical MRI system on primary human hepatocytes labeled using micrometer-sized iron oxide particles (MPIOs). Methods: HuH7 tumor c...
Article
Full-text available
Decellularization of pancreata and repopulation of these non-immunogenic matrices with islets and endothelial cells could provide transplantable, endocrine Neo- Pancreata. In this study, rat pancreata were perfusion decellularized and repopulated with intact islets, comparing three perfusion routes (Artery, Portal Vein, Pancreatic Duct). Decellular...
Article
Over the past 50 years, image-guided procedures have been established for a wide range of applications. The development and clinical translation of new treatment regimens necessitate the availability of suitable animal models. The juvenile Göttingen minipig presents a favourable profile as a model for human infants. However, no information can be f...
Article
Decellularization of livers is a well-established procedure. Data on different reseeding techniques or the functional evolution and re-organization processes of repopulated grafts remains limited. We established a proprietary, customized bioreactor to repopulate decellularized rat livers (n = 21) with primary rat hepatocytes (150 x 106 cells) via t...
Article
Acute hepatitis E virus infection after liver transplant is a challenging clinical phenomenon. Due to its unspecific clinical and histological presentation, the diagnosis of acute or chronic hepatitis E virus infection can be difficult in unclear cases of elevated liver enzymes. Here, we report the case of a 56-year-old male patient who presented t...
Article
Full-text available
Background: Extrahepatic bile duct injuries remain severe complications during cholecystectomies and often require reconstruction by bilioenteric anastomosis (i.e., hepaticojejunostomy), which comes with further long-term complications (e.g., recurring ascending cholangitis, secondary biliary cirrhosis). In the case of inherent extrahepatic biliar...
Article
Primary human hepatocytes are widely used for basic research, pharmaceutical testing, and therapeutic concepts in regenerative medicine. Human hepatocytes can be isolated from resected liver tissue. Preoperative portal vein embolization (PVE) is increasingly used to decrease the risk of delayed postoperative liver regeneration by induction of selec...
Article
Full-text available
Decellularization and recellularization of parenchymal organs may enable the generation of functional organs in vitro, and several protocols for rodent liver decellularization have already been published. We aimed to improve the decellularization process by construction of a proprietary perfusion device enabling selective perfusion via the portal v...
Conference Paper
Introduction: A cell based treatment for type 1 diabetes can significantly reduce the occurence of life-threatening complications, like hypoglycemic episodes, and progression of diesease-associated co-morbidities. Islet cell transplantation is able to achieve insulin independence in 40 – 60% of cases. But unfortunately graft-site-specific issues st...
Conference Paper
Introduction: Repopulation of decellularized pancreas extracellular matrices (dPECMs) with islets offers the possibility to generatefunctional endocrine pancreata. Transplantation of these in vitro engineered organs implicates several advantages compared to conventional pancreas or islet transplantation like e.g. prevention of post-transplantation...
Article
One approach of regenerative medicine to generate functional hepatic tissue in vitro is decellularization and recellularization, and several protocols for the decellularization of livers of different species have been published. This appears to be the first report on rat liver decellularization by perfusion under oscillating pressure conditions, in...
Article
Full-text available
Decellularization and recellularization of parenchymal organs may facilitate the generation of autologous functional liver organoids by repopulation of decellularized porcine liver matrices with induced liver cells. We present an accelerated (7 h overall perfusion time) and effective protocol for human scale liver decellularization by pressure-cont...

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