Operations and Business Environment - Fresenius Medical Care

on the basis of growing clinical experience and new
medical knowledge.
The methods used so far exclusively aim to remove toxins,
a function that a healthy liver would usually carry out.
But a natural liver performs many other tasks as well.
In addition to detoxification, it synthesizes (produces)
numerous compounds that are important for the organism
and releases various substances into the bloodstream,
including different blood coagulation factors
and proteins such as albumin. The liver replacement therapies
used today cannot cover most of the functions of
the liver and are therefore unsatisfactory.
In the past years, progress has been made in the cultivation
of cells on different substrates contributing to
the development of a “bioartificial liver”. In a bioartificial
liver, living hepatocytes (liver cells), which are
arranged in an appropriate device and around which
the patient’s blood flows, take over all the functions
of a natural liver. One problem with this system is the
limited availability of suitable hepatocytes. Preparation
of natural donor organs and the use of rapidly growing
liver carcinoma cells have not been successful thus
far. Obtaining hepatocytes with the help of adult stem
cell techniques is the current focus of our research
activities in this area.
Technological Trends
General medical technology trends can also be observed
in dialysis. Thanks to new technological processes and
materials, the size, weight and energy consumption
of individual components and hence entire machines
can be reduced and new functions can be integrated
into medical equipment. We carefully consider these
possibilities when developing and fine-tuning its products.
One product that could potentially result from
these advancements would be a portable artificial kidney.
Only prototypes have been developed thus far.
It will become standard practice to link medical equipment
with clinic-based data entry systems. Today, we are
continually taking advantage of the opportunities afford-
ed by information technology. Such database connections
would enable patients to be treated better, more safely
and less expensively in the future. With its various IT
products from the fields of peritoneal and hemodialysis,
Fresenius Medical Care benefits from close ties with
its clinics. Further information can be found
from page 87
onwards in the section “Clinical Databases”.
Research Cooperation
The clinic-related research activities discussed above
require close cooperation, not only between our worldwide
development departments, but also with qualified
clinical partners. In hemodialysis, our clinics are the first
contact for our developers in research activities with
strong practical objectives. We carry out these projects
together with selected competence centers, depending
on the focus of the individual clinics and their experience
in specialized areas.
When it comes to research activities that focus at least
partially on basic dialysis treatment issues, we work together
successfully with the Renal Research Institute (RRI)
in the U.S., which in turn cooperates with top-notch
academic medical institutions in the United States. We
founded the RRI together with the Beth Israel Medical
Center. A project launched at the RRI in 2005 investigating
the advantages of daily hemodialysis treatment of
patients with ESRD continued in 2006. For the study, patients
are dialyzed six days a week rather than every other
day. The quality of the treatment and the financial implications
arising from daily dialysis are being examined.
The project is scheduled to be continued into 2008.
We have developed a technology together with the RRI
which makes it possible to establish the hydration level
of patients with chronic kidney failure. The partial or
complete lack of urine elimination in patients leads to
a severe disturbance of their fluid balance. As a result,
patients often suffer from chronic fluid retention, which
is a major mortality cause. Thanks to the new technology,
over-hydration can be easily detected and remedied
at an early stage.
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Fresenius Medical Care 2006