Fresenius Kabi is investing about €35 million to modernize the company’s production facility in Louviers, France. Two sterilization units and two production lines for Freeflex® infusion bags will be housed in a 3,300-square-meter (35,500-square-foot) building being constructed on the site and will replace the existing production facilities. In this way, the company will continue to ensure the availability of these important products into the future. The modernization is scheduled for completion before the end of 2023. Fresenius Kabi employs some 370 people at the Louviers plant and has a total of about 1,500 employees in France.
Fresenius Kabi is investing about €35 million to modernize the company’s production facility in Louviers, France. Two sterilization units and two production lines for Freeflex® infusion bags will be housed in a 3,300-square-meter (35,500-square-foot) building being constructed on the site and will replace the existing production facilities. In this way, the company will continue to ensure the availability of these important products into the future. The modernization is scheduled for completion before the end of 2023. Fresenius Kabi employs some 370 people at the Louviers plant and has a total of about 1,500 employees in France.
With our interactive tool you can analyze and graph a variety of key figures of the Fresenius Group and the business segments on an annual and quarterly basis.
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T: +49 (0) 6172 608-5167
florian.feick@fresenius.com
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Alternative Performance MeasuresPlease find below a selection of frequently asked questions and the respective answers (FAQ). If you cannot find the answer to your question please do not hesitate to contact the Investor Relations team at your convenience.
Where does Fresenius SE & Co. KGaA have its registered office?
The company’s registered office is situated at Else-Kröner-Str. 1, 61352 Bad Homburg v.d.H., Germany.
When was Fresenius SE & Co. KGaA founded?
The origins of Fresenius SE & Co. KGaA date back to the firm “Dr. Eduard Fresenius, Chemisch-pharmazeutische Industrie”, which was founded in 1912 by Dr. Eduard Fresenius, the proprietor of the Hirsch pharmacy in Frankfurt am Main. The founder’s wide-ranging contacts to doctors and scientists served as the foundations for the company and shaped its extensive portfolio of products. The company was converted into the joint stock company Fresenius AG at the end of 1981 in order to secure its continuity. The conversion of Fresenius SE into a partnership limited by shares (KGaA) took effect on January 28, 2011 with the entry of Fresenius SE & Co. KGaA in the commercial register of Bad Homburg municipal court.
What are Fresenius SE & Co. KGaA’s core businesses?
Fresenius is a global healthcare group. We offer system-critical products and services for leading therapies for care of critically and chronically ill patients.
The Fresenius Group comprises the Operating Companies Fresenius Kabi and Fresenius Helios and the Investment Company Fresenius Medical Care. Each business segment is market leader in a major growth area of healthcare. In May 2024, Fresenius announced a structured exit from the Investment Company Vamed and completes the strategic portfolio restructuring as part of #FutureFresenius. As of Q2 2024, Vamed is no longer a reporting segment of Fresenius.
Fresenius has successfully completed the deconsolidation of Fresenius Medical Care: The change in legal form was entered in the commercial register on November 30, 2023.
How many employees does Fresenius SE & Co. KGaA have?
The Group has 176,486 employees as of December 2024 (December 31, 2023: 193,865).
When does Fresenius SE & Co. KGaA’s financial year end?
The financial year ends on December 31.
How does Fresenius SE & Co. KGaA draw up its Group financial statement?
Fresenius SE & Co. KGaA ("Fresenius") reports since January 1, 2017 in accordance with International Financial Reporting Standards (IFRS).
Fresenius, as a publicly traded company based in a European Union member country, is required to prepare and publish its consolidated financial statements in accordance with International Financial Reporting Standards (IFRS) pursuant to Section 315e of the German Commercial Code (HGB).
How high were total assets and shareholders’ equity?
The Group had total assets of €43,550 million as of December 31, 2024 (December 31, 2023: €45,284 million) while shareholders’ equity including minority interests amounted to €20,290 million (December 31, 2023: €19,651 million).
What were Fresenius SE & Co. KGaA’s revenue?
Revenue of €21,526 million were achieved in the financial year 2024.
How do financial analysts’ current estimates look like?
For an overview of analysts’ current recommendation please click here.
When will the next earnings results be released?
For an overview of our next earnings releases please click here.
Which key performance indicators are important for Fresenius SE & Co. KGaA?
The Management Board has revised the financial management system for the fiscal year 2023.
In the Fresenius Financial Framework, organic revenue growth represents the key performance indicator for the Group’s growth and that of the business segments. With the Fresenius Financial Framework, we have defined annual organic revenue growth ranges (ambition levels) for the operating companies. No annual ambition levels were defined for organic sales growth of the investment companies.
As part of the Fresenius financial framework, we have defined annual margin bands (ambition levels) for the business segments. These serve as an ambition level for the internal management of our business sectors and are benchmarked against leading competitors. The annual EBIT margin is defined as earnings before interest and taxes divided by revenue. To improve comparability of operating performance over several periods, the earnings figure is adjusted for special items where necessary.
At Group level, we primarily use earnings before interest and taxes (EBIT) and EBIT growth in constant currency. To improve comparability of operating performance over several periods, the earnings figure is adjusted for special items where necessary.
For an overview of our performance measures please click here.
When was the IPO of Fresenius?
The Fresenius preference shares were admitted to trading in December 1986. The Fresenius ordinary shares were admitted to trading in July 1992. The shares were listed on the stock exchanges in Frankfurt, Düsseldorf and Munich. In January 2011, the legal form of Fresenius SE was changed to a partnership limited by shares (KGaA) and all preference shares were mandatorily converted into ordinary shares.
Under what quotation symbols are the Fresenius SE & co. KGaA shares to be found?
The Bloomberg symbol of the Fresenius SE ordinary share on XETRA is FRE GR. The Reuters symbol on XETRA is FREG.de.
Why did Fresenius SE & Co. KGaA not pay a dividend for the 2023 financial year?
In 2023, the Fresenius Management Board decided to make use of the compensation and reimbursement payments for German hospitals in the amount of up to €300 million (from the current perspective) provided for by the ‘Energy Relief Package’ (‘Entlastungspaket Energiehilfen’) under the Hospital Financing Act (‘Krankenhausfinanzierungsgesetz’) to cover increased energy costs. This meant that Fresenius was subject to the related restrictions imposed by the legislator, including not being allowed to distribute a dividend for the 2023 fiscal year.
Notwithstanding the legally required suspension of dividend payments for the fiscal year 2023, Fresenius maintains its dividend policy for the future. In line with its progressive dividend policy, Fresenius continues to aim to increase the dividend in line with growth in earnings per share (in constant currency, before special items), or at least maintain the dividend at the previous year's level.
Will Fresenius resume its dividend policy after the suspension of the dividend payment in 2023 for the financial year 2024?
As part of the full year reporting in February 2025, Fresenius defined a new dividend policy designed to ensure attractive shareholder returns while maintaining strategic flexibility. Going forward, Fresenius will pay out 30 to 40% of its Group core net income excluding Fresenius Medical Care and before special items as dividend.
For fiscal year 2024, Fresenius will propose a dividend of €1.00 per share. The dividend proposal is a strong increase over the 2022 base and demonstrates Fresenius’ improving financial strength and its commitment to delivering shareholder value.
Further information on the announcement can be found here.
What is the structure of Fresenius SE & Co. KGaA’s capital stock?
The subscribed capital of Fresenius SE & Co. KGaA amounted to 563,237,277 ordinary shares as of December 31, 2024 (December 31, 2023: 563,237,277). The shares of Fresenius SE & Co. KGaA are non-par-value bearer shares. Each share represents € 1.00 of the capital stock.
Who are the principal shareholders of Fresenius SE & Co. KGaA?
The Else Kröner-Fresenius-Stiftung is the largest shareholder of Fresenius SE & Co. KGaA, holding approximately 27% of the voting capital. An overview of our shareholder structure can be found here.
Where can I find information on the Fresenius share price?
Under "Share Price" you can find our interactive tool that allows you to analyze and graph the Fresenius SE & Co. KGaA share price.
Where can I find information on the Fresenius’ financial targets?
Under "Outlook" you can find the outlook for the Fresenius Group and each of the business segments.
When will the next Annual General Meeting take place?
The Annual General Meeting of Fresenius SE & Co. KGaA is scheduled to take place on May 23, 2025, at the Congress Center, Messe Frankfurt, Ludwig-Erhard-Anlage 1, 60327 Frankfurt am Main, Germany.
When was the record date in 2024?
he record date for the 2024 Annual General Meeting was April 25, 2024. In order to participate in the Annual General Meeting and to exercise voting rights shareholders have to submit special proof of share ownership which refers to the beginning of the record date, i.e. 24.00 h CEST.
The record date does not result in a blocking period during which it is not allowed to sell shares. Even in the event of full or partial disposal of the shareholding following the record date, only the shares owned by the shareholder on the record date will be relevant for participation in the Annual General Meeting and the scope of voting rights, i.e. disposal of shares after the record date will not affect entitlement to participate in the Annual General Meeting and the scope of voting rights. This also applies if (additional) shares are purchased after the record date. Persons who do not own any shares on the record date, and become shareholders only after the record date, are not entitled to participate in the Annual General Meeting and to exercise voting rights.
Can every shareholder attend the Annual General Meeting?
All shareholders were able to follow the Annual General Meeting online or appoint a representative as long as he/she fulfils the conditions stated in the agenda. However, only holders of ordinary shares have a voting right as a general rule. You can enter the agenda on our website as from the day of its publication.
How and where can I register for the Annual General Meeting?
The invitation with the agenda of the Annual General Meeting will be delivered to you by your depositary bank before the Annual General Meeting. Enclosed with the invitation is a letter from your depositary bank with which you can order the admission ticket either for yourself or for someone else of your choice.
Is it possible to receive a free copy of the documents regarding the Annual General Meeting? Who should I contact?
Of course you can receive a free copy of the documents regarding the Annual General Meeting. Please contact our Investor Relations department.
What does sustainability mean for Fresenius?
Sustainability is deeply embedded in our thinking and our actions – at all levels of our company.
At Fresenius, we focus on the opportunities that arise from sustainable thinking. And translate them into sustainable actions which create tangible impact. Because we at Fresenius are - Committed to Life!
In our hospitals, we do everything we can to accelerate the recovery and well-being of our patients through personalized, holistic treatments that combine excellence in care with a positive experience for body and soul. All of this is only possible thanks to the commitment and expertise of our employees worldwide. For them, we strive to create the best possible working environment in which everyone can develop and realize their full potential. Gaining and retaining top talent is a key priority for us.
Healthy people need a healthy home. This is why our commitment to life naturally means caring for the planet we live on. Reducing our environmental footprint helps to safeguard ecosystems and thus strengthens our society. For example, we continuously reduce our consumption of water and aim to increase energy efficiency.
Our Code of Conduct and our commitment to respect internationally proclaimed Human Rights build the ethical foundation of Fresenius’ Sustainability Agenda.
For a detailed overview of our Sustainability Ambition and related goals please refer to our Sustainability Highlights Report.
How is Sustainability/ESG (Environment, Social, Governance) anchored in the Groups’ organization?
Sustainability at Fresenius is the responsibility of the Group Management Board member for Legal, Compliance, Risk Management, ESG, Human Resources, and the business segment Fresenius Vamed (“ESG Board Member”).
The Group ESG function acts as a competence center within the Fresenius Group. The function monitors regulatory developments, identifies key issues, and defines priorities and opportunities for the implementation of the ESG strategy. It supports Group-wide implementation and reviews progress as part of the annual reporting. Throughout the year, it aligns repeatedly with all Group functions and the ESG officers in the business segments to consider the respective business models and ensure the feasibility of measures. The Group ESG function is also responsible for internal and external stakeholder communication and, together with the Group Controlling function, for non-financial reporting.
The Group Function Risk & Integrity is responsible for our Code of Conduct and manages inter alia issues relating to human rights and compliance. Amongst other key functions relevant for implementation of our Sustainability Agenda are Group Cybersecurity Office and data protection.
The ESG Steering Committee, which was created at the end of 2023, consists of the ESG Board member (Chair), the Group ESG function, defined functions at Group level, and the ESG officers of the business segments. The committee is tasked with providing information on current developments, deciding on appropriate measures to improve ESG performance, and monitoring the progress of implementation.
Furthermore, Fresenius has appointed an independent ESG Advisory Board for sustainability issues in 2024. Four leading international experts from science, business, and consulting provide advice to the Management Board member responsible for ESG topics to support our sustainability efforts.
Does the Management Board compensation include ESG related targets?
Sustainability related performance targets are an integral part of the Compensation System 2023+ for the Management Board members. These reflect our company strategy and enforce our commitment to environmental, social, and governance (ESG) aspects. The ESG targets are integrated into both – short-term and long-term variable compensation.
The non-financial performance targets relevant for the Short-Term Incentive cover the key sustainability topics of medical quality / patient satisfaction and employees. The Long-Term Incentive includes a CO2 emission reduction target in line with externally communicated company goal of becoming climate neutral by 2040.
For further details please refer to our Annual Report 2023.
What are the most important sustainability topics at Fresenius?
Our priorities derive from our materiality analysis performed during 2020. As a result, we have identified six main topic clusters and 15 individual topics. We review the material topics annually to ensure that they reflect the latest developments.
Most relevant for our business is the well-being of our patients. We aspire to take responsibility for the well-being of millions of patients. Numerous measures are in place to ensure that our products and services are accessible to more and more people. We strive for highest patient and product safety and follow strict requirements to ensure quality and safety.
All of this is only possible thanks to the commitment and expertise of our employees worldwide. For them, we strive to create the best possible working environment in which everyone can develop and realize their full potential. Gaining and retaining top talent is a key priority for us.
Healthy people need a healthy home. This is why our commitment to life naturally means caring for the planet we live on. Reducing our environmental footprint helps to safeguard ecosystems and thus strengthens our society. For example, we continuously reduce our consumption of water - one of our most precious resources and increase energy efficiency.
Further, Compliance and Integrity and Digital transformation and innovation are core to the success of our business.
For more information on our material topics please refer to our Non-Financial Report.
How is Fresenius rated by the ESG rating agencies?
Leading ESG rating agencies regularly evaluate and review our sustainability performance. An overview of the current ESG ratings is available on our website.
What is Fresenius' position on environmental protection?
As a health care Group, Fresenius feels a responsibility to protect the environment and use natural resources carefully because only a healthy environment can be a home for healthy people. It is important for us to avoid possible negative effects on the environment and health. To this end, we identify and evaluate potential hazards and take the necessary measures to protect the environment. In our Group-wide materiality analysis, we identified the following topics for our internal environmental management strategy as particularly relevant to our core business:
• Water management
• Waste and recycling management
• Climate protection – energy and emissions
For further information please consult our Non-Financial Report.
Does Fresenius have a climate target?
Fresenius has set a climate target for the Group. By 2030, we will reduce Scope 1 & 2 emissions by 50%; by 2040, we want to achieve climate neutrality in our own operations (baseline: 2020). We will reach net zero by 2050. For further information please refer to our Sustainability Highlights Report.
How does Fresenius implement the company commitment to respect human rights?
As a global healthcare company, we see respect for human rights as an integral part of our responsibility.
Medical care for patients and the well-being of our employees are among the most important engagement areas of our human rights due diligence. Our commitment to human rights extends beyond our own company operations and core business. In line with our human rights due diligence program, we take human rights aspects into account when selecting and cooperating with our suppliers and business partners, too.
Further information is available on our website and in our Non-Financial Report.
Where can I find sustainability related key figures?
Our interactive tool offers a variety of key figures of the Fresenius Group and the business segments. These figures can individually be analyzed and visualized.
What is good corporate governance for Fresenius?
The Supervisory Board and the Management Board are committed to responsible management that is focused on achieving a sustainable increase in the value of the Company. Long-term corporate strategies, solid financial management, strict adherence to legal and ethical business standards, and transparency in corporate communication are key factors.
Our Corporate Governance Declaration can be found here.
How is the compensation of the Management Board structured at Fresenius?
On May 17, 2023, the Annual General Meeting approved a new compensation system for the members of the Management Board. In particular, the Compensation System 2023+ provides for a new plan for long-term variable compensation that takes even greater account of promoting the long-term and sustainable development of the Company. In addition, the aspect of sustainability has been anchored even more strongly in the long-term variable compensation.
Details on the compensation of the Management Board are available in the AGM invitation 2023.
How is the compensation of the Supervisory Board structured at Fresenius?
On May 21, 2021, the Annual General Meeting approved a new compensation system for the members of the Supervisory Board.
Details on the compensation of the Supervisory Board are available in the AGM invitation 2021.
What is an American Depositary Receipt (ADR)?
An American Depositary Receipt (ADR) is a U.S. dollar denominated negotiable certificate that represents ownership of shares in a non-U.S. compan
Each ADR is issued by a U.S. depositary bank (which is a bank in the United States which oversees all the stock transfer and agency services in connection with a depositary receipt program) and represents one or more shares of a foreign stock or a fraction of a share. If investors own an ADR they have the right to obtain the foreign stock it represents, but U.S. investors usually find it more convenient to own the ADR. The price of an ADR is often close to the price of the foreign stock in its home market, adjusted for the ratio of ADRs to foreign company shares. ADRs were specifically designed to facilitate the purchase, holding and sale of non-U.S. securities by U.S. investors.
Fresenius ADRs represent Fresenius’ local shares deposited with the depositary bank (Deutsche Bank Trust Company Americas), to underlie such certificates and carry the rights attached to them as detailed in the Depositary Agreement. Holders of ADRs receive dividends in U.S. dollars and have the right to vote on shareholders resolutions, where applicable.
What is the difference between an ADR and an ADS?
An ADR (American Depositary Receipt) is a negotiable certificate issued by a depositary bank representing a specific number of shares of a non-U.S. company traded on a U.S. stock exchange. An ADS (American Depositary Share) is the share issued under the ADR agreement which is actually traded. Although the terms ADR and ADS are often used interchangeably, the difference is that an ADR is the certificate while the ADSs are the shares.
What are the benefits of ADRs to U.S. investors?
U.S. investors may prefer to purchase ADRs rather than local shares in the issuer’s home market because ADRs trade, clear and settle in U.S. Dollars and according to U.S. market conventions. ADRs also allow easy comparison to securities of similar companies as well as access to price and trading information. Holders of ADRs also receive dividends in U.S. dollars.
What is an ADR ratio?
The ADR ratio is the relation between the number of ADRs and the number of local shares. Four Fresenius ADRs represent one Fresenius local share, i.e. the ratio is 4:1. The ratio was changed in conjunction with the stock split on August 1, 2014, becoming effective on August 4, 2014. Before that the ADR ratio was 8:1.
How can I buy Fresenius ADRs?
Fresenius ADRs can be purchased like any other stocks, through your U.S. banks and brokers.
Where are Fresenius ADRs traded?
Fresenius ADRs are traded in the U.S. OTC (over the counter) market under the ticker symbol FSNUY. The Cusip Number is 35804M105.
What is an OTC Market?
The OTC market is the market for over-the-counter securities in the United States. This is where sponsored Level I ADR programs are traded.
How are dividends paid?
ADR holders will receive the dividend in U.S. dollars. The depositary bank typically announces the final ADR dividend rate following conversion into U.S. dollars. ADR rates and pay dates will be published on www.adr.db.com
Where do I get information and updates on Fresenius?
Financial and stock information is available here.
Trading information is readily available on our depositary bank’s website and on the website of OTC Markets.
Who is Fresenius’ depositary bank, transfer agent, registrar and exchange agent for ADR shares?
Fresenius’ ADR program is administered by Deutsche Bank Trust Company Americas (Deutsche Bank). As the depositary bank, Deutsche Bank performs the following roles for ADR holders as further detailed in the Deposit Agreement:
- Records and maintains the register of ADR holders,
- Is the stock transfer agent,
- Distributes dividends in U.S. dollars,
- Facilitates the voting process and the exercise of the voting rights of ADR holders at any Company
- General Meeting if permitted by the Company and the Depositary Agreement,
- Issues and cancels Fresenius American Depositary Receipts (ADRs),
- Can distribute Company circulars and General Meetings (including Annual General Meeting) documentation, if applicable.
For those holders who are not registered because their ADRs are held through a ‘Street name’ (nominee account), your nominee will receive Company documents from time to time from Deutsche Bank to distribute to ADR holders. You need to make arrangements with your nominee if you wish to receive such documents and to be able to exercise your vote through the depositary bank at General Meetings (if applicable).
How can I contact Deutsche Bank?
Contact details for ADR brokers & institutional investors:
US - Tel: +1 212 250 9100
UK - Tel: +44 207 547 6500
e-mail: adr@db.com
Contact details for registered ADR Holders:
Deutsche Bank Shareholder Services
American Stock Transfer & Trust Company
Peck Slip Station
P.O. Box 2050
New York, NY 10272-2050
e-mail: DB@amstock.com
Toll-free number: +1 800 937 5449
Direct Dial: +1 718 921 8124
http://www.amstock.com/
How do I convert my local shares into ADRs?
Converting local shares into ADRs must be done through a broker, investment advisor or directly through Deutsche Bank Trust Company Americas. You can contact Deutsche Bank broker services desk on +1 212 250 9100 or +44 207 547 6500, or by email on adr@db.com.
What if I lose my ADR certificate, dividend check or tax voucher?
If you do not hold via a broker, bank or nominee, please contact our transfer agent:
Deutsche Bank Shareholder Services
American Stock Transfer & Trust Company
Peck Slip Station
P.O. Box 2050
New York, NY 10272-2050
e-mail: DB@amstock.com
Toll-free number: +1 800 937 5449
Direct Dial: +1 718 921 8124
What if I have more than one ADR certificate? Can they be combined?
Yes. Certificates can be combined by contacting our transfer agent:
Deutsche Bank Shareholder Services
American Stock Transfer & Trust Company
Peck Slip Station
P.O. Box 2050
New York, NY 10272-2050
e-mail: DB@amstock.com
Toll-free number: +1 800 937 5449
Direct Dial: +1 718 921 8124
How can I get the latest news of Fresenius?
Stay informed about the latest news and developments at our Group by subscribing to our Investor News and/or to the Fresenius Brief News. These services are free of charge and may be cancelled at any time. Our Information & Order Service is available here. Please scroll fully down this page.
Where can I find financial and sustainability key figures?
Our interactive tool offers a variety of key figures of the Fresenius Group and the business segments on an annual and quarterly basis. These figures can individually be analyzed and visualized.
In this year's ranking, the non-profit organization CDP has confirmed Fresenius' classification in the second-highest category B. Fresenius is thus once again one of the leading companies in the health care sector. Companies in categories A and B are characterized by transparency, coordinated climate protection measures and the implementation of corresponding best-practice approaches. CDP is one of the most renowned climate and environmental rankings in the capital market. More than 590 investors use the annual results to evaluate climate protection activities and climate-related risks and opportunities of the companies assessed.
In this year's ranking, the non-profit organization CDP has confirmed Fresenius' classification in the second-highest category B. Fresenius is thus once again one of the leading companies in the health care sector. Companies in categories A and B are characterized by transparency, coordinated climate protection measures and the implementation of corresponding best-practice approaches. CDP is one of the most renowned climate and environmental rankings in the capital market. More than 590 investors use the annual results to evaluate climate protection activities and climate-related risks and opportunities of the companies assessed.
In this year's ranking, the non-profit organization CDP has confirmed Fresenius Medical Care' classification. The company was again listed in the second highest categories B in the area climate and B- in the area water. Fresenius Medical Care is thus once again one of the leading companies in the health care sector. Companies in categories A and B are characterized by transparency, coordinated climate protection measures and the implementation of corresponding best-practice approaches. CDP is one of the most renowned climate and environmental rankings in the capital market. More than 590 investors use the annual results to evaluate climate protection activities and climate-related risks and opportunities of the companies assessed.
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Following the boys' eight weeks of hospitalization, the Schimmels are all together at home again. -
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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 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.”
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Jamie can already practice the guitar again, -
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and Kilian ride his bicycle in the yard.
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.
Related Links
Making mistakes to avoid them A little heart at the center of a complex surgery Fresenius Helios HospitalsContact
Helios Kliniken GmbH
Friedrichstr. 136
10117 Berlin
Germany
T +49 30 521 321-0
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.”
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At the surgeon's console, Dr. Mille directs the movements of the robot arms. -
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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.
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Helios Kliniken GmbH
Friedrichstr. 136
10117 Berlin
Germany
T +49 30 521 321-0
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.”
Contact
Helios Kliniken GmbH
Friedrichstr. 136
10117 Berlin
Germany
T +49 30 521 321-0