The hours-long wait is agonizing: Every time Mareen and Roy Schimmel glance at the clock, it seems like time is standing still. As their son Kilian undergoes a heart transplant, his brother Jamie is fighting for his life in the intensive care unit.

(Published: June 2021)

Kilian, the somewhat taller and stronger of the 13-year-old twins, first experienced heart pain in 2017, after a soccer practice. His parents thought it was only a persistent cold, but took him to a doctor anyway. The physician opted to refer his young patient to the Fresenius Helios Heart Center Leipzig for a more detailed diagnosis.

“The diagnosis by pediatric cardiology specialists showed Kilian had a genetic heart weakness. We knew we were in good hands at Helios so, at first, we accepted the diagnosis calmly,” said Mareen. As a precaution, the parents took Jamie, who has a slighter build than his brother, to a pediatrician in 2019 for a thorough examination. The blood test, as was the case earlier with Kilian, indicated he also had a genetic heart disorder: In medical terms, a cardiac insufficiency.

This was the start of the family’s ordeal. In May 2020, the parents had to call for emergency assistance after Jamie displayed symptoms consistent with the onset of a stroke. “As before with Kilian, Jamie was transported from Magdeburg to the Heart Center Leipzig, where they implanted a pacemaker with an integrated defibrillator,” said Roy. Shortly thereafter, doctors had to perform the same operation on Kilian.

The sense of security that followed proved to be short lived. The boys’ strength declined steadily to the point that they could rarely walk more than a few hundred meters without taking a break. Doctors at the Heart Center Leipzig placed both boys on the high-priority list for a donor heart.

On the afternoon of February 21, 2021, Mareen got a phone call. “The heart center told us there was an organ available for Kilian. I cannot describe what went through my head when I heard this,” she said. A short time later an ambulance stood at the door. As this was happening, Jamie was already at the heart center, where he had been undergoing extended treatment.

Preparations at the Fresenius Helios hospital began under an established routine. Kilian was prepared for the operation and received anesthesia around midnight. Prof. Dr. Diyar Saeed, Managing Senior Physician for Heart Transplants and Artificial Hearts, and Dr. Marcel Vollroth, Senior Physician for Pediatric Heart Surgery, performed the life-saving surgery. They were assisted by an experienced team of anesthesiologists and nurses. Of the 339 heart transplants performed in 2020 in Germany, 41 were done at the Heart Center Leipzig. “However,” said Dr. Vollroth, “all of them were performed on adults. The last time we transplanted a child’s heart here was in 2010.”

Doctors at the Heart Center Leipzig placed both boys on the high-priority list for a donor heart.

At about 4:30 in the morning, Mareen and Roy received a call that all had gone well. “Professor Saeed told us there were no complications during the operation and that Kilian was doing as well as could be expected,” Mareen said. 

But this good news was dampened by Jamie’s condition. The boy was noticeably declining, weakening drastically to the point where his condition had become life threatening. The reason Kilian and not Jamie had received the new heart was the size of the donor organ. “It was too big for Jamie,” explained Dr. Vollroth. Early on, the parents had ruled out making a decision on which boy should be given priority. “For us, the boys were never in a competition with each other,” said Roy.

To keep Jamie alive, doctors decided to implant an artificial heart. This decision, however, was soon superseded: Out of the blue came word from Eurotransplant, an organization distributing donor organs in eight European countries, that they also had a heart for Jamie. “This meant spooling back to the beginning for the entire operation team,” said Dr. Vollroth. Same doctors, same team and the same professional process. For Jamie, this start to a new life began around midnight and ended nearly five hours later.

“For us, the boys were never in a competition with each other.”

Following eight weeks of hospitalization, the family is together again. The boys have gotten used to their new lives as transplant patients with the accompanying mountain of pills. Visits with friends and relatives will have to wait. Even without the COVID-19 pandemic, the risk of infection would be too great. For now, Jamie must content himself with practicing the guitar and Kilian with riding his bicycle in the yard.

Everybody at the Heart Center Leipzig is both happy and proud of the achievement. It was the first time a situation like this had occurred in a cardiac unit anywhere in the world. The successful transplantations for the twins also had a signal function. “In the future, we will again place emphasis on performing heart transplants for children from about seven years of age,” promised Dr. Vollroth, who can count on continued support from Prof. Saeed.

The robot arms move above the patient’s stomach as if guided by an invisible hand. Monitors on each side of the operating table show an oversized, 3-D image of the stomach’s interior. Two meters (about six feet) away, Dr. Markus Mille sits fully absorbed at the control console.

(Published: February 2021)

His hands are directing the movements of four robot arms: Three of them hold surgical instruments – scissors, forceps and tongs – while the fourth holds the camera that is transmitting the images from inside the stomach cavity. The doctor’s feet, meanwhile, are operating pedals that allow him to coordinate the robot’s actions and engage the individual arms. To get a better feel for what he is doing, he has removed his shoes.

The patient has colon cancer. Dr. Mille, Chief Senior Physician of the General and Visceral Surgery Clinic at Helios Hospital Erfurt under Chief Physician Prof. Dr. Albrecht Stier, starts by removing the tumor and a piece of the large intestine. He then reconnects the large intestine with the small intestine. To make space for the instruments between the abdominal wall and the organs, and perform what is known as a hemicolectomy, carbon dioxide has been injected to expand the stomach to twice its normal size.

Robot-assisted surgery enables even more precision

In a consultation with Dr. Mille at the hospital in Erfurt, in the eastern German state of Thuringia, the patient opted to undergo the operation with the robot. “In cases like this,” the surgeon explains, “we can operate much more precisely with robot-assisted intervention – it’s easier on the patient and we can discharge them sooner from the hospital.” The surgical incisions are at most two centimeters – less than an inch – in length, and leave only small scars.

Using a robot in the operating room also has advantages for surgeons. The robot arms allow supple movements with a greater range of motion. This makes possible a more precise intervention than the conventional minimally invasive surgery, which uses fixed instruments. Surgeons assume a sitting position during the operation, which prevents weariness and back pain. In addition, the expanded monitor display of the area being operated on facilitates recognition of minute, delicate structures such as nerves and blood vessels.

“It is very impressive what can be achieved with the help of a robot. Now I am convinced: This is the future.”

The robot is called the da Vinci Xi, and costs about €2 million ($2.4 million). It is not capable of action on its own, but can perhaps best be described as an extended arm of the surgeon – one capable of neutralizing any shaking or vibrations of the hands. The surgical system consists of three components: The surgeon’s console, a patient cart – where the instruments are installed – and a so-called vision cart, which contains the computer devices that control communications between the components.  

“The first time I heard about operating-room robots like these, I thought they were just some technical gimmick,” says Dr. Mille. “Then I immersed myself in the topic and undertook several study visits. It is very impressive what can be achieved with the help of a robot. Now I am convinced: This is the future.”

Before using the robot for the first time on a patient, the surgeon underwent weeks of comprehensive preparation with multiple training courses and study visits. Using computer simulation, he learned how to move the robot’s arms correctly, then traveled to a special robotics training center in Belgium to use the da Vinci Xi for the first time on a model.

“Stepping up to the operating table and just starting, which you may know from before, doesn’t work here,” Dr. Mille explains. “You must learn systematically how to handle the technology and deal with the different way of operating, and then train intensively.” The surgical team that works with the medical robots also received special training.

Use of robot-assisted surgery is growing

The colon surgery was Dr. Mille’s 88th surgical procedure using the robot. One operation that remains vivid in his memory was the removal of an 85-year-old patient’s esophagus: For this complex surgery, Dr. Mille – in a first in Thuringia state and at Helios – deployed the robot twice during the same procedure, once on the stomach and then in the chest area. Eight days later, the patient could leave the hospital.

In addition to General and Visceral Surgery, the robot is being used at Helios Hospital Erfurt in Gynecology, Thoracic Surgery and Urology. It can assist in surgery on various organs in the stomach, chest areas and pelvic areas, such as the lungs, liver, uterus or prostate.

Surgery is also being performed with da Vinci surgical systems at several other Helios hospitals, including in the German cities of Wuppertal, Schwerin, Krefeld, Duisburg and Aue. This is part of a larger trend in medicine: According to the manufacturer, more than 7.2 million operations were carried out with this surgical system in 2019.

Following the birth of her son Joona in April 2018, Lea Zerbe is certain: “I want to become a midwife.” It is a courageous decision that comes from the heart. She leaves her old job and, after her paternity leave ends, begins studies to become a midwife.

(Published: July 2020)

Lea had always been torn between two main interests: “On the one hand I love everything creative; culture and music – on the other hand I have always been a people person.” After her pregnancy, the 28-year-old made up her mind. “People are more important.”

Upon leaving high school, her outlook was a little bit different. Lea considered several career paths before deciding on a curriculum of cultural studies and business administration at the University of Lüneburg in northern Germany – opening the door to a career in the world of culture. “Even then I knew that it probably wouldn’t be permanent,” she recalls. “I’m not an office person. I want to work with people as much and as closely as possible.”

With her studies completed, she found work organizing music and film festivals, but it fell short of her expectations. “I had played with the idea of becoming a professional midwife for a long time, but I couldn’t really come to grips with it until I got pregnant,” Lea says, thinking back to the time when she not only was carrying new life, but was also ready to try something new. Lea wanted to know everything about the development of a child, churning through book after book and taking courses. Pregnancy was a beautiful experience for her, during which she learned more and more about the midwife profession.

The shortage of midwives in Germany is a big problem. For that reason, expectant mothers are advised to look for a midwife right from the onset of pregnancy, in order to secure someone who can lend support in the early stages. Even if this is often a time of great joy, there are also uncertainties and complaints; nausea, for example. And should it come to a tragic situation like a miscarriage or infant mortality, a midwife can lend support and make the necessary arrangements.

“Through my own pregnancy, I saw how important the work of a midwife is, and how good it feels when someone is there to help the expectant family along,” Lea says. And this ultimately led her to apply for a trainee position at Helios Mariahilf Hospital. The dual study program lasts four years and culminates in a Bachelor of Science degree. Together with two other trainees, she is learning how to best accompany women before, during and after birth.

The profession is multifaceted, with many options for trainee midwives to find employment in an area that suits them. The duties of a midwife extend well beyond those which are visible in a hospital. Births, naturally, are at the center of what midwives do. However, their duties can cover the entire spectrum from family planning through the woman’s pregnancy and on to postnatal care.

Midwives can perform the same precautionary examinations as gynecologists during pregnancy – with the exception of ultrasound. Midwives also help with the complaints and burdens that can result from a pregnancy. In addition, they prepare expectant mothers and their partners for the birth, and make home visits to advise on supplementary foods and breastfeeding in the days following birth. Some midwives also teach, explaining the stages of pregnancy and birth as part of sex education for primary-school students.

Lea is optimistic about her future as a midwife. “In school, they always talk about the supreme discipline of birth, but I think it is the complete package that is important. I simply want to be there for women in this most special time in their lives.”

They are two little charming heroines: When Emma and Ana romp gleefully around the living room, look at their toys with curiosity, or crawl at lightning speed on their knees across the room and make it acoustically known when something is not okay, you would think you were in a totally normal nursery somewhere in Switzerland. If you take a closer look, however, you will see that the two happy children are connected to two colorful bags via white spiral cables that peek out from underneath their clothes. These are the infusion lines leading to the infusion pumps and bags that supply the nutrient solutions for the parenteral nutrition that the two children have needed ever since they were born.

(Published: February 2019)

Parenteral nutrition becomes necessary when a person’s stomach or intestines cannot perform their designated tasks flawlessly, for example due to an operation or a disease. The special liquidized nutrition and the fitting device for administering it are designed to bypass the usual process of digestion and supply the patient with all necessary nutrients such as amino acids, lipids, minerals, and vitamins.

How long these administering processes take depends on the individual case of the patient – Ana needs infusions 18 hours a day and Emma 21 hours a day. Therefore, the parenteral nutrition has to be administered overnight while they are asleep and for several hours during the day. Portable infusion pumps and a backpack system ensure as much freedom of movement as possible for the children. Remarkably, the two see their particular circumstances and all the resulting implications as something totally normal. Their mothers preparing the infusions in the evening before they go to bed, connecting the infusions to the backpacks, the occasional beep the infusion pumps make when an infusion tube gets blocked, or the cleaning of the catheter are all part of their daily rituals. Ana is already able to put her backpack on by herself.

Even interaction with siblings and other children is per the customary rules of a child’s world, be it playing roughly or, through Emma’s masterful charm offensive, getting a boy to wear her backpack, for example. For Ana, going for walks together with her parents and the family dog Aiva is always a special event. Provided the catheter is sufficiently protected, the girls are able to go swimming and splash around, something which creates lots of happy moments, particularly in the summer months out in the garden. Despite their parenteral nutrition, eating and drinking together at the family table allows them to feel part of the family unit and to enjoy their favorite meal.

Ana and Emma’s families got to know each other through the pediatric clinic and have remained on close terms with each other ever since. In addition to the social side of things, the practical tips and mutual exchange of experience are invaluable as far as daily caregiving tasks are concerned. Being accurate throughout the overall treatment and maintaining high levels of hygiene are basic prerequisites for successful and safe parenteral nutrition at home. Both families perform these challenging tasks unfailingly. A specialized outpatient care organization (Kinderspitex) is on hand to provide assistance when needed. At the pediatric clinic, the children are examined and have various lab tests done every month.

The employees in the FresuCare department of Fresenius Kabi in Switzerland are in charge of planning and organizing the supply of nutrient solutions and all of the devices needed for providing pediatric patients with parenteral nutrition at home. Our FresuCare colleagues identify the individual needs of the patients at their home and act as a go-between between families, the pediatric clinic, and the logistics department of Fresenius Kabi. In-house staffs process the families’ online orders, arrange deliveries, and lay the administrative foundations for the direct settlement of costs with the insurers. The FresuCare organization of Fresenius Kabi Switzerland has been able to expertly provide patients with comprehensive clinical nutrition at home for over 25 years, thereby creating significant value for chronically and critically ill patients.

Ana and Emma’s parents especially value the fact that, by being well prepared, the whole family can even go on long journeys and, as a result, are also able to go and see relatives who live far away or visit holiday destinations.
 

A car rattles as it turns the corner. It pushes and weaves its way through the streets of downtown Frankfurt – passing bicycles, pedestrians and horse-drawn carriages. The year is 1912. The car belongs to the Hirsch Pharmacy, one of the oldest apothecaries in the city. And the pharmacy head is Dr. Eduard Fresenius.

Stored in the trunk of the car are various preparations for treatment of skin conditions and colds, as well as sterile solutions for injection. The driver is on his way to sanitariums located on the outskirts of Frankfurt. He makes regular deliveries of Hirsch Pharmacy products to the spas. Pedestrians watch as the car goes by. This is an age when traffic on the streets is characterized by horse-drawn conveyances and bicycles – the car draws attention. Nevertheless Eduard Fresenius invests in the new technology as soon as he takes over the pharmacy from this father. Speedy delivery of pharmaceuticals to patients is a priority for him.

The Hirsch Pharmacy has a long tradition: Its history can be traced back to the 15th Century. The Fresenius family becomes the owners in the 1870s. When Eduard Fresenius takes charge, he has big plans. In 1912 he founds “Dr. Eduard Fresenius chemisch-pharmazeutische Industrie,” in a back room of the pharmaceutical wholesaler. This lays the foundation for today’s healthcare group. A modest pharmaceutical company is born out of the pharmacy laboratory.

Solutions made from the purest distilled water are a specialty of Eduard Fresenius. The quick success of the company also is due to the numerous collaborations that Eduard Fresenius enters into with well known physicians. For Nobel Prize winner Paul Ehrlich, Fresenius develops the “Injectio Fresenius” solvent used in his syphilis cure. Under the name Ampuwa, an abbreviation for ampule water, the solvent to this day is part of the Fresenius inventory."A pharmacy today? we need to expand it or add something new to it." (Dr. Eduard Fresenius)

Eduard Fresenius runs the pharmacy in Frankfurt until 1934, when he relocates company headquarters to Bad Homburg. The company founder is full of ideas on how to gain recognition for his company. Often he is ahead of his time with these ideas. Early in the 1930s he begins distributing a Hirsch Pharmacy magazine for customers. A few years later he opens a diet pavilion in Bad Homburg. During summer months guests consume fresh fruit and vegetable juices. Fresenius employees also prepare special drinks for diet patients based on doctors’ prescriptions. Particularly popular were the milk mix drinks, an early form of the milkshake.

Realizing great ideas is expensive. In financial matters, Eduard Fresenius is unlucky. And the years to come are challenging ones for the businessman. During the Second World War he loses contact with a lot of important business partners. He does not join the Nazi party. Supplying the German army with medications like the Freka frostbite cream helps for a time to maintain company production.

The end of the war finds Eduard Fresenius standing before the rubble that was his existence: Allied bombs have completely destroyed the Hirsch Pharmacy. Raw material shortages make production in Bad Homburg impossible. In the midst of reorganizing the company, Dr. Fresenius dies suddenly in 1946. He names his foster daughter, Else Kröner, née Fernau, as benefactor of his estate.

Just 26 years old, she inherits the Hirsch Pharmacy and the leadership of the company. As a newly licensed pharmacist, Else Kröner knows her way around pharmaceutics, but when it comes to business management she soon reaches her limits. She obtains the needed skills by attending evening classes at a private business school in Frankfurt. She spends nearly 12 hours a day in the company and doggedly works to rebuild the firm during difficult years. Her efforts earn her a great deal of respect and admiration among the staff. She eventually turns over running the Hirsch Pharmacy to a fellow pharmacist. Her main focus now is running the company in Bad Homburg. With a lot of effort, she and her eventual husband, Hans Kröner, develop Fresenius over the following years into a global healthcare group.

Else and Hans Kröner realize they can only keep the company going if they succeed in growing with new ideas. With their employees, they begin searching for new horizons – and soon find one. Since the early days, the expertise of the company has been infusion solutions. Over the next years Fresenius continuously expands its product range, developing new nutrition- and volume replacement solutions such as Generika, which are administered by infusion. The company does more than develop its solutions, it also improves their packaging. Into the 1960s infusion solutions are still stored in glass bottles. Fresenius succeeds in developing special plastic bags and bottles. These are easy to handle, and break proof plastic containers become an immediate market success.

As a medium-sized company producing solutions for dialysis, Fresenius first comes into contact with dialyzers in the 1960s. Dialyzers are blood filters used during a dialysis treatment of patients with chronic kidney failure to purify their blood. This treatment is life saving for kidney patients – but at the time it is very laborious and expensive. Only a few patients can be treated. Through media reports, Fresenius learns of the desperate situation facing many kidney patients, and begins to import American dialysis machines. As they maintain the machines, Fresenius workers gain technical know-how. In the 1970s the company develops its first dialysis machines in a newly acquired plant in Schweinfurt. Constant advancements in materials and technology over the next years enable the company to continue improving dialysis treatment for kidney patients. Fresenius in the 1980s succeeds in developing a capillary made from polysulfone that purifies blood almost as efficiently as a human kidney. To this day blood filters made from this material are the standard in dialysis.

Numerous strategic acquisitions are a hallmark of the next years: 1996 brings the merger of the Fresenius dialysis unit with American dialysis provider National Medical Care to form a new division, Fresenius Medical Care. As a result Fresenius becomes one of the world’s largest providers of dialysis services. In the same year, Fresenius acquires a majority stake in the hospital services provider VAMED AG. Originally founded to plan and build the Vienna General Hospital, VAMED becomes a new business leg for the healthcare group. Acquisition in 1999 of the international infusion business of Pharmacia & Upjohn leads to creation of the business unit Fresenius Kabi.

There are more acquisitions around the world, through which the company also enters the US pharmaceuticals market and assumes a leading role in the global market for generic IV drugs. In 2005, Fresenius takes over the private hospital chain HELIOS Kliniken GmbH and fuses it with Wittgensteiner Kliniken, which it acquired in 2001. This creates the Fresenius Helios division. Fresenius Helios in 2013 acquires 41 hospitals from Rhön-Kliniken, making it the largest hospital operator in Germany.

Hardly any European company in past years has been able to match the dynamic growth of Fresenius. Currently more than 300,000 employees around the world work for the healthcare group. What began as a small pharmacy laboratory is today a leading global healthcare group with a presence in more than 80 countries. The small family operation that Dr. Eduard Fresenius led until his death is different from today’s company in many respects. However the fundamental values of our company are unchanged. To preserve lives and improve the quality of life for sick people has been our motivation for more than 100 years. “Forward thinking healthcare,” symbolizes what we want in the future: constant improvements in medicine for more and more people.

100 Years of Fresenius

Fresenius has been working for over 100 years to improve the lives of seriously ill people around the world. This film, made on the occasion of the company's Centennial in 2012, tells the company's history through the stories of people who have been helped and are still being helped by Fresenius.