{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:58Z","timestamp":1786978318178,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2016,7,26]],"date-time":"2016-07-26T00:00:00Z","timestamp":1469491200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2016,7,26]],"date-time":"2016-07-26T00:00:00Z","timestamp":1469491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:p>\n                    Liver transplantation (LT) is a well\u2010accepted procedure for end\u2010stage liver disease in Germany. In 2015, 1489 patients were admitted to the waiting list (including 1308 new admissions), with the leading etiologies being fibrosis and cirrhosis (n = 349), alcoholic liver disease (n = 302), and hepatobiliary malignancies (n = 220). Organ allocation in Germany is regulated within the Eurotransplant system based on urgency as expressed by the Model for End\u2010Stage Liver Disease score. In 2015, only 894 LTs (n = 48 from living donors) were performed at 23 German transplant centers, reflecting a shortage of organs. Several factors may contribute to the low number of organ donations. The German transplant legislation only accepts donation after brain death (not cardiac death), whereas advances in neurosurgery and a more frequently requested \u201cpalliative care\u201d approach render fewer patients suitable as potential donors. The legislation further requires the active consent of the donor or first\u2010degree relatives before donation. Ongoing debates within the German transplant field address the optimal management of patients with alcoholic liver cirrhosis, hepatocellular carcinoma (HCC), and cholangiocarcinoma and measures to increase living donor transplantations. As a result of irregularities at mainly 4 German transplant centers that were exposed in 2012, guiding principles updated by the German authorities have since implemented strict rules (including internal and external auditing, the 8\u2010eyes principle, mandatory repeated testing for alcohol consumption) to prohibit any manipulations in organ allocation. In conclusion, we will summarize important aspects on the management of LT in Germany, discuss legal and organizational aspects, and highlight challenges mainly related to the relative lack of organ donations, increasing numbers of extended criteria donors, and the peculiarities of the recipient patients.\n                    <jats:italic toggle=\"yes\">Liver Transplantation 22 1136\u20131142 2016 AASLD<\/jats:italic>\n                  <\/jats:p>","DOI":"10.1002\/lt.24461","type":"journal-article","created":{"date-parts":[[2016,4,15]],"date-time":"2016-04-15T11:52:41Z","timestamp":1460721161000},"page":"1136-1142","source":"Crossref","is-referenced-by-count":89,"title":["Liver transplantation in Germany"],"prefix":"10.1097","volume":"22","author":[{"given":"Frank","family":"Tacke","sequence":"first","affiliation":[{"name":"Department of Medicine III,RWTH University Hospital Aachen,Aachen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela C.","family":"Kroy","sequence":"additional","affiliation":[{"name":"Department of Medicine III,RWTH University Hospital Aachen,Aachen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula","family":"Barreiros","sequence":"additional","affiliation":[{"name":"German Organ Transplantation Foundation (DSO), Region Mitte,Mainz,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf P.","family":"Neumann","sequence":"additional","affiliation":[{"name":"Department of Transplant Surgery,RWTH University Hospital Aachen,Aachen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2016,7,26]]},"reference":[{"key":"lt24461-bib-0001-20240115","first-page":"46","article-title":"[ALT screening for chronic liver diseases: scrutinizing the evidence; 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