Lebertransplantation – aktuelle Aspekte der Allokation, Indikation und Strategien zur Erweiterung des Spenderpools

 

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Zusammenfassung

Die Lebertransplantation ist heute eine etablierte Behandlungsmethode des terminalen Leberversagens und der damit verbundenen Komplikationen. Die vorliegende Arbeit fasst die aktuellen Aspekte der Allokation, der Transplantationsindikation sowie Strategien zur Erweiterung des Spenderpools zusammen. Neben der Sicherung des Langzeiterfolgs und der Lebensqualität der transplantierten Patienten steht das Problem des Spenderorganmangels an erster Stelle weltweit. Um den Mangel zu verwalten, wird viel über Indikationen, insbesondere bei Malignomen, diskutiert. Schwerpunkt bleibt unseres Erachtens die Ausnutzung und Erweiterung des Spenderorganpools. Hier sind noch viele logistische und medizinische Aspekte optimierbar. Es bleibt aber auch eine öffentliche und politische Ebene der Diskussion bis hin zur Novellierung des Transplantationsgesetzes offen, die dringend einer Verbesserung im Sinne der Patienten bedarf.

Abstract

Liver transplantation is nowadays an established treatment option for end-stage liver disease and the associated complications. In this article, we summarise the actual aspects of allocation, indication for transplantation as well as approaches for donor pool expansion in the field of liver transplantation in Germany. Beside the maintenance of long-term survival and quality of life, the actual donor organ shortage is the most important issue worldwide. While trying to control this shortage, there is a lot of discussion about the transplantation for malignant liver disease. In our opinion, the focus in this topic should be the utilisation and expansion of the donor pool. There are many logistic and medical aspects which could be optimised. Furthermore, there are open questions in public and political discussions (up to the revision of the transplantation law) which should be improved for the purpose of the waiting list patients.

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