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Book ; Thesis: Einfluss der chirurgischen Teamerfahrung auf den Erfolg von Lebertransplantationen

Dahl, Priscila / Schrem, Harald Heinrich

2021

Institution	Medizinische Hochschule Hannover Klinik für Allgemein-, Viszeral- und Transplantationschirurgie
Author's details	vorgelegt von Priscila Dahl ; aus der Klinik für Allgemein-, Viszeral- und Transplantationschirurgie der Medizinischen Hochschule Hannover ; Betreuer der Arbeit: Prof. Dr. med. Harald Schrem, MBA
Language	German
Size	1 ungezähltes Blatt, 70 Blätter, Diagramme
Publishing place	Hannover
Publishing country	Germany
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Dissertation, Medizinische Hochschule Hannover, 2023
HBZ-ID	HT030671032
Database	Catalogue ZB MED Medicine, Health

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2024 E 467	order for loan	Magazin

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Book ; Thesis: Risikoanalyse der Kurz- und Langzeitmortalität lebertransplantierter Patienten mit einem MELD-Score ≥ 30

Hartmann, Catharina / Schrem, Harald Heinrich

2017

Institution	Medizinische Hochschule Hannover Medizinische Hochschule Hannover / Stabsstelle MHH - CRC Core Facility
Author's details	vorgelegt von Catharina Hartmann aus Hamburg ; aus der Core Facility Qualitätsmangement und Health Technology Assessment Transplantation der Medizinischen Hochschule Hannover ; Wissenschaftliche Betreuung: PD Dr. med. Harald Schrem
Language	German ; English
Size	31 Blätter, 1 Diagramm, 30 cm
Publishing place	Hannover
Publishing country	Germany
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Dissertation, Medizinische Hochschule Hannover, 2018
Note	Enthält 1 Sonderabdruck aus: Annals of Transplantation ; 20.2015. Seite 59-69
HBZ-ID	HT020123204
Database	Catalogue ZB MED Medicine, Health

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2019 E 683	order for loan	Magazin

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Book ; Conference proceedings ; Thesis: Gallenwegskomplikationen nach Lebertransplantation

Gutcke, André / Schrem, Harald Heinrich

Erfahrungen der letzten 30 Jahre und aktuelle Risikofaktoren

2018

Institution	Medizinische Hochschule Hannover
Event/congress	Core Facility Qualitätsmanagement und Health Technology Assessment in der Transplantation
Author's details	vorgelegt von Stefan André Gutcke ; aus der Core Facility Qualitätsmanagement in der Transplantation des Integrierten Forschungs- und Behandlungszentrums Transplantation der Medizinischen Hochschule Hannover ; Betreuer der Arbeit: Prof. Dr. med. Harald Schrem
Language	German ; English
Size	35 Blätter, Diagramme, 30 cm
Publishing place	Hannover
Publishing country	Germany
Document type	Book ; Conference proceedings ; Thesis
Thesis / German Habilitation thesis	Dissertation, Medizinische Hochschule Hannover, 2021
Note	Text auf Deutsch, Sonderabdruck auf Englisch ; Enthält 1 Zeitschriftenaufsatz aus "World Journal of Hepatology", Jg. 9 (2017)
HBZ-ID	HT021118147
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Factors influencing deceased organ donation rates in OECD countries: a panel data analysis.

Qu, Zhi / Oedingen, Carina / Bartling, Tim / Schrem, Harald / Krauth, Christian

BMJ open

2024 Volume 14, Issue 2, Page(s) e077765

Abstract: Objectives: This study aims to investigate factors with a significant influence on deceased organ donation rates in Organisation for Economic Co-operation and Development (OECD) countries and determine their relative importance. It seeks to provide the ... ...

Abstract	Objectives: This study aims to investigate factors with a significant influence on deceased organ donation rates in Organisation for Economic Co-operation and Development (OECD) countries and determine their relative importance. It seeks to provide the necessary data to facilitate the development of more efficient strategies for improving deceased organ donation rates. Design: Retrospective study. Setting: Publicly available secondary annual data. Participants: The study includes 36 OECD countries as panel members for data analysis. Outcome measures: Multivariable panel data regression analysis was employed, encompassing data from 2010 to 2018 for all investigated variables in the included countries. Results: The following variables had a significant influence on deceased organ donation rates: 'opt-in' system (β=-4.734, p<0.001, ref: 'opt-out' system), only donation after brain death (DBD) donors allowed (β=-4.049, p=0.002, ref: both DBD and donation after circulatory death (DCD) donors allowed), number of hospital beds per million population (pmp) (β=0.002, p<0.001), total healthcare employment pmp (β=-0.00012, p=0.012), World Giving Index (β=0.124, p=0.008), total tax revenue as a percentage of gross domestic product (β=0.312, p=0.009) and percentage of population aged ≥65 years (β=0.801, p<0.001) as well as high education population in percentage (β=0.118, p=0.017). Conclusions: Compared with the promotion of socioeconomic factors with a positive significant impact on deceased organ donation rates, the following policies have been shown to significantly increase rates of deceased organ donation, which could be further actively promoted: the adoption of an 'opt-out' system with presumed consent for deceased organ donation and the legal authorisation of both DBD and DCD for transplantation.
MeSH term(s)	Humans ; Organisation for Economic Co-Operation and Development ; Retrospective Studies ; Tissue and Organ Procurement ; Organ Transplantation ; Tissue Donors
Language	English
Publishing date	2024-02-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-077765
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Book ; Thesis: Mutationen im Präs-Genom des Hepatitis-B-Virus vor und nach Lebertransplantation

Schrem, Harald Heinrich

1997

Author's details	vorgelegt von Harald Heinrich Schrem
Language	German
Size	85 Bl. : Ill., graph. Darst.
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Hannover, Med. Hochsch., Diss., 1997
HBZ-ID	HT007804441
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Systematic review on the involvement and engagement of patients as advisers for the organisation of organ transplantation services.

Qu, Zhi / Oedingen, Carina / Bartling, Tim / Krauth, Christian / Schrem, Harald

BMJ open

2023 Volume 13, Issue 5, Page(s) e072091

Abstract: Objectives: This systematic review aims to derive practical lessons from publications on patient involvement and engagement in the organisation of organ transplantation services.: Design: This systematic review was conducted according to the ... ...

Abstract	Objectives: This systematic review aims to derive practical lessons from publications on patient involvement and engagement in the organisation of organ transplantation services. Design: This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Inclusion criteria for the analysis of publications in English cited in the databases PubMed and Web of Science until 6 December 2022 required that patients participated as advisers in the organisation of organ transplantation services. Quality assessment was performed using the Guidance for Reporting Involvement of Patients and the Public (GRIPP) 2 small form and the Critical Appraisal Skills Programme (CASP) tool for the assessment of the risks of bias. Results: Deployed search strings identified 2263 records resulting in a total of 11 articles. The aims and strategies, deployed methods, observed effects, observed barriers and proposed improvements for the future varied vastly. All reported that well-developed programmes involving and engaging patients at an organisational level provide additional benefits for patients and foster patient-centred care. Lessons learnt include: (1) to empower patients, the information provided to them should be individualised to prioritise their needs; (2) financial as well as organisational resources are important to successfully implement patient involvement and engagement; (3) systematic feedback from patients in organisational structures to health providers is required to improve clinical workflows and (4) the consideration of ethical issues and the relationship between investigators and participating patients should be clarified and reported. Conclusions: Actionable management recommendations could be derived. The quantitative impact on clinical outcome and economic clinical process improvements remains to be investigated. Study quality can be improved using the GRIPP 2 guidance and the CASP tool. Prospero registration number: CRD42022186467.
MeSH term(s)	Humans ; Patient Participation/methods ; Patients ; Patient-Centered Care ; Organ Transplantation
Language	English
Publishing date	2023-05-10
Publishing country	England
Document type	Systematic Review ; Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-072091
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Setting Organ Allocation Priorities: A Discrete Choice Experiment with German Patients and Their Relatives.

Bartling, Tim / Oedingen, Carina / Schrem, Harald / Kohlmann, Thomas / Krauth, Christian

Patient preference and adherence

2023 Volume 17, Page(s) 827–838

Abstract: Purpose: Organ transplantation systems benefit from guidelines that are harmonious with the preferences of the people involved. Discrete choice experiments are useful tools for eliciting preferences.: Patients and methods: This study evaluated the ... ...

Abstract	Purpose: Organ transplantation systems benefit from guidelines that are harmonious with the preferences of the people involved. Discrete choice experiments are useful tools for eliciting preferences. Patients and methods: This study evaluated the preferences of patients and their relatives (n=285) to identify their priorities in organ allocation using a discrete choice experiment. In eight hypothetical allocation decisions, the participants were asked to select the candidate they considered the most suitable The candidates differed in years of life gained after transplantation, quality of life after transplantation, waiting time until transplantation, age, compliance and social support. Results: The most important aspects for setting priority in organ allocation were lack of compliance (β= -2.5, p<0.001) and good quality of life after transplantation (β = +1.4, p<0.001). The lack of social support (ß = -0.8, p<0.05) and the more years of life gained after transplantation (β = +0.5, p<0.001) had less but still a significant amount of influence on this decision, while the waiting list was not considered significantly important (β = 0.1, p>0.05). The comparison of the different relations to transplantation showed that life years gained after transplantation was of high relevance to posttransplant patients (+10 years: β = +0.709, p<0.001 / +15 years: β = +0.700, p<0.001) and of no importance to waitlisted patients (+10 years: β = +0.345, p>0.05 / + 15 years: β = +0.173, p>0.05) and relatives (+ 10 years: β = +0.063, p>0.05 / +15 years: β = +0.304, p>0.05). Conclusion: This study provides useful insights into the unique perspective of patients and their relatives on priority-setting in the allocation of donor organs that should be reflected in improved donor organ allocation rules.
Language	English
Publishing date	2023-03-24
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2455848-5
ISSN	1177-889X
ISSN	1177-889X
DOI	10.2147/PPA.S402203
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Article: How Should Deceased Donor Organs Be Allocated? The Patient's Perspective Derived from Semi-Structured Interviews.

Bartling, Tim / Oedingen, Carina / Kohlmann, Thomas / Schrem, Harald / Krauth, Christian

Patient preference and adherence

2022 Volume 16, Page(s) 2375–2385

Abstract: Purpose: The gap between the supply and demand for deceased donor organs is increasing worldwide, while patients on waiting lists for organ transplantation die. This situation requires ethical donor organ allocation rules. The patients' perspective on ... ...

Abstract	Purpose: The gap between the supply and demand for deceased donor organs is increasing worldwide, while patients on waiting lists for organ transplantation die. This situation requires ethical donor organ allocation rules. The patients' perspective on donor organ allocation rules offers a highly relevant and unique perspective that may differ from the perspectives of physicians and the general public. Patients and methods: Semi-structured telephone interviews were conducted with the regional group coordinators of the federal self-help organization for organ transplanted patients and their relatives in Germany in early 2021. Twelve interviews were conducted with patients and relatives of transplantation patients who received transplants for the affected organs including the lungs, heart, kidney, and liver. Transcripts were analyzed using the deductive framework method which was based on an earlier study. All criteria were reported following the COREQ statement. Results: Participants emphasized aspects of "medical urgency" and "effectiveness/benefit" of transplantation and associated trade-offs as well as the recipient's responsibility for organ failure ("own fault"), the appreciation for the gifted graft and the patient's capability of taking care of it ("appreciation/responsibility"). Patients acknowledged that urgent patients should be prioritized and they showed a clear preference toward allocation rules that strive to maximize both the life years and quality of life gained by transplantation. Conclusion: The patients' perspective is unique in that patients agree on certain rules for allocation and share many preferences, but also have a hard time finding clear cutoff points when considering selecting a participant for allocation. Patient representatives should therefore be consulted in the debate on donor organ allocation rules.
Language	English
Publishing date	2022-08-30
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2455848-5
ISSN	1177-889X
ISSN	1177-889X
DOI	10.2147/PPA.S372603
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Article ; Online: 'As a surgeon, I am obliged to every single patient': evaluation of focus group discussions with transplantation physicians on the allocation of donor organs.

Bartling, Tim / Oedingen, Carina / Schrem, Harald / Kohlmann, Thomas / Krauth, Christian

Current opinion in organ transplantation

2021 Volume 26, Issue 5, Page(s) 459–467

Abstract: Introduction: Organ transplantation is the last resort for many patients. The ubiquitous shortage of suitable donor organs raises the question of best-justifiable allocation worldwide. This study investigates how physicians would allocate donor organs.!# ...

Abstract	Introduction: Organ transplantation is the last resort for many patients. The ubiquitous shortage of suitable donor organs raises the question of best-justifiable allocation worldwide. This study investigates how physicians would allocate donor organs. Methods: Focus group discussions with a total of 12 transplant surgeons and 2 other transplant-related physicians were held at the annual conference of the German Transplantation Society (Oct 2019). Three groups discussed aspects of 'egalitarianism', 'effectiveness/benefit', 'medical urgency', 'own fault', 'medical background' and 'socio-demographic status'. Results and discussion: It was observed that physicians often find themselves confronted with conflicts between (a) trying to advocate for their individual patients versus (b) seeing the systemic perspective and understanding the global impact of their decisions at the same time. The groups agreed that due to the current shortage of donor organs in the German allocation system, transplanted patients are often too sick at the point of transplantation and that a better balance between urgency and effectiveness is needed. The aspects of 'effectiveness' and 'urgency' were identified as the most challenging issues and thus were the main focus of debate. The dilemmas physicians find themselves in become increasingly severe, the larger the shortage of suitable donor organs is.
MeSH term(s)	Focus Groups ; Humans ; Organ Transplantation ; Surgeons ; Tissue Donors ; Tissue and Organ Procurement
Language	English
Publishing date	2021-07-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1390429-2
ISSN	1531-7013 ; 1087-2418
ISSN (online)	1531-7013
ISSN	1087-2418
DOI	10.1097/MOT.0000000000000908
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Article ; Online: Learning surgical knot tying and suturing technique - effects of different forms of training in a controlled randomized trial with dental students.

Dasci, Sükran / Schrem, Harald / Oldhafer, Felix / Beetz, Oliver / Kleine-Döpke, Dennis / Vondran, Florian / Beneke, Jan / Sarisin, Akin / Ramackers, Wolf

GMS journal for medical education

2023 Volume 40, Issue 4, Page(s) Doc48

Abstract: Objective: The acquisition of surgical skills requires motor learning. A special form of this is intermanual transfer by transferring motor skills from the nondominant hand (NDH) to the dominant hand (DH). The purpose of this study was to determine the ... ...

Abstract	Objective: The acquisition of surgical skills requires motor learning. A special form of this is intermanual transfer by transferring motor skills from the nondominant hand (NDH) to the dominant hand (DH). The purpose of this study was to determine the learning gains that can be achieved for the DH by training with the DH, the NDH, and by non-surgical alternative training (AT). Methods: 124 preclinical (n=62) and clinical (n=62) dental students completed surgical knot tying and suturing technique training with the DH, with the NDH, and an AT in a controlled randomized trial. Results: A statistically significant learning gain in knot tying and suture technique with the DH was evident only after training with the DH when compared to training with the NDH (p<0.001 and p=0.004, respectively) and an AT (p=0.001 and p=0.010, respectively). Of those students who achieved a learning gain ≥4 OSATS points, 46.4% (n=32) benefited in their knot tying technique with the DH from training with the DH, 29.0% (n=20) from training with the NDH, and 24.6% (n=17) from an AT while 45.7% (n=32) benefited in their suturing technique with the DH from training with the DH, 31.4% (n=22) from training with the NDH, and 22, 9% (n=16) from an AT. Conclusions: Training with the DH enabled significantly better learning gains in the surgical knot tying and suturing techniques with the DH.
MeSH term(s)	Humans ; Students, Dental ; Clinical Competence ; Learning ; Internship and Residency ; Suture Techniques/education
Language	English
Publishing date	2023-06-15
Publishing country	Germany
Document type	Randomized Controlled Trial ; Journal Article
ISSN	2366-5017
ISSN (online)	2366-5017
DOI	10.3205/zma001630
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