{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:14:40Z","timestamp":1789470880525,"version":"build-2803163510"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008375","name":"University of Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Chirurgie"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:sec>\n                <jats:title>Hintergrund<\/jats:title>\n                <jats:p>Der weltweite Organmangel ist das gr\u00f6\u00dfte Hindernis, um die dringend notwendigen Lebertransplantationsaktivit\u00e4ten auszuweiten. Um die Anzahl gespendeter Organe zu erh\u00f6hen, wurde in vielen europ\u00e4ischen L\u00e4ndern neben der Spende nach Hirntod (\u201edonation after brain death\u201c [DBD]) auch die Spende bei prim\u00e4rem Herz-Kreislauf-Tod (\u201edonation after circulatory death\u201c [DCD]) und sekund\u00e4rem Hirntod eingef\u00fchrt.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ziel der Arbeit<\/jats:title>\n                <jats:p>Es erfolgt eine Zusammenfassung der legalen und ethischen Aspekte des Herz-Kreislauf-Todes, des Prozesses der DCD-Spende, der klinischen Ergebnisse insbesondere in Bezug auf das Organassessment vor einer geplanten DCD-Lebertransplantation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>In Europa haben 11\u00a0L\u00e4nder aktive DCD-Lebertransplantationsprogramme, und 2023 wurden in Europa insgesamt 1230\u00a0DCD-Lebertransplantationen durchgef\u00fchrt. Den h\u00f6chsten Anteil machten DCD-Lebertransplantationen in Belgien (52,8\u202f%), Holland (42,8\u202f%) und der Schweiz (32,1\u202f%) aus. Die ad\u00e4quate Selektion von Spendern und Empf\u00e4ngern ist bei DCD-Transplantationen entscheidend, und die Verwendung von DCD-Lebern h\u00e4ngt insbesondere von der Bereitschaft zur routinem\u00e4\u00dfigen Maschinenperfusion ab. Die Spitzenreiter Belgien, Frankreich und Italien implantieren rund 68\u201374\u202f% aller DCD-Organe. Bei ad\u00e4quatem Organassessment sind die Langzeitergebnisse von DBD- und DCD-Lebertransplantationen vergleichbar. Die hypotherme oxygenierte Maschinenperfusion (HOPE) erlaubt neben der Einsch\u00e4tzung des mitochondrialen Schadens gleichzeitig eine mitochondriale Protektion durch die Oxygenierung. Die Etablierung eines aeroben Stoffwechsels in Mitochondrien in der Hypothermie f\u00fchrt zu einer Reduktion toxischer Metabolite und zur Wiederherstellung der ATP(Adenosintriphosphat)-Speicher, dadurch kommt es anschlie\u00dfend bei der Implantation zu einer \u201eReperfusion Light\u201c.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Schlussfolgerungen<\/jats:title>\n                <jats:p>Die Erweiterung des Spenderpools durch DCD-Spender wirkt der weltweiten Organknappheit entgegen. Bei ad\u00e4quater Selektion und routinem\u00e4\u00dfigem Organassessment sind sowohl Kurzzeit- als auch Langzeitergebnisse von DBD- und DCD-Lebertransplantationen vergleichbar.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00104-024-02094-x","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T20:19:30Z","timestamp":1715804370000},"page":"618-626","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Organspende und Organassessment nach prim\u00e4rem Herz-Kreislauf-Stillstand und sekund\u00e4rem Hirntod","Organ donation and organ assessment after primary circulatory death and secondary brain death"],"prefix":"10.1007","volume":"95","author":[{"given":"Philip C.","family":"M\u00fcller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beat P.","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Dutkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,15]]},"reference":[{"key":"2094_CR1","first-page":"659","volume":"117","author":"TE Starzl","year":"1963","unstructured":"Starzl\u00a0TE, Marchioro\u00a0TL, Vonkaulla\u00a0KN et\u00a0al (1963) Homotransplantation Of The Liver In Humans. 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