{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T10:12:27Z","timestamp":1696587147398},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>Indikation zur Transplantation \u2013 aktuelle Entwicklungen Der Wandel in den Indikationen zur Transplantation setzt sich weiter fort, Hauptindikationen werden die Sp\u00e4tfolgen der nichtalkoholischen und alkoholassoziierten Lebererkrankungen und das hepatozellul\u00e4re Karzinom (HCC) sein. Zirrhosen auf dem Boden von Virushepatitiden spielen zunehmend eine untergeordnete Rolle.<\/jats:p><jats:p>Ist die 6-Monats-Alkoholkarenz eine zwingende Voraussetzung f\u00fcr die Transplantation?\u2002Die Richtlinien der Bundes\u00e4rztekammer fordern grunds\u00e4tzlich eine Alkoholabstinenzperiode von 6 Monaten. Wissenschaftliche Daten zeigen, dass insbesondere Patienten mit Erstmanifestation einer akuten Alkoholhepatitis, die nicht auf die medikament\u00f6se Therapie anspricht, in besonderer Weise von einer Transplantation profitieren k\u00f6nnen. F\u00fcr diese Patienten kann eine individuelle Ausnahme f\u00fcr eine Transplantationslistung beantragt werden.<\/jats:p><jats:p>Das hepatozellul\u00e4re Karzinom au\u00dferhalb der Mailand-Kriterien \u2013 Transplantation nach \u201eDownstaging\u201c\u2002Zahlreiche Studien belegen, dass mithilfe effektiver \u201eDownstaging\u201c-Therapien und unter Ber\u00fccksichtigung des Biomarkers AFP eine Subgruppe von Patienten mit initialem HCC au\u00dferhalb der Mailand-Kriterien definiert werden kann, die eine sehr g\u00fcnstige und der von Patienten innerhalb der Mailand-Kriterien vergleichbare postoperative Prognose besitzt.<\/jats:p><jats:p>Zu krank f\u00fcr eine Transplantation? Das akut-auf-chronische Leberversagen (ACLF)\u2002Selbst Patienten mit dekompensierter Zirrhose mit Mehrorganversagen, wie es im Rahmen eines ACLF definiert ist, k\u00f6nnen erfolgreich und mit einer guten Langzeitprognose transplantiert werden. Das Zeitfenster, in welchem dies m\u00f6glich ist, ist jedoch kurz.<\/jats:p><jats:p>Spenderorganmangel \u2013 Verwendung HBV- und HCV-positiver Organe und neue Chancen durch die Maschinenperfusion\u2002Die Transplantation von Organen chronisch HCV- und HBV-infizierter Spender stellt durch die exzellenten Behandlungsm\u00f6glichkeiten bei diesen viralen Infektionen eine relevante Strategie zur Vergr\u00f6\u00dferung des Spenderpools dar. Zus\u00e4tzlich gewinnt die Maschinenperfusion als neuartige Methode der Organkonservierung bzw. der Organaufbereitung an Bedeutung.<\/jats:p>","DOI":"10.1055\/a-0982-0737","type":"journal-article","created":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T22:31:20Z","timestamp":1597357880000},"page":"1124-1131","source":"Crossref","is-referenced-by-count":0,"title":["Aktuelle Entwicklungen bei der Lebertransplantation \u2013 Wo stehen wir?"],"prefix":"10.1055","volume":"145","author":[{"given":"Niklas F.","family":"Aehling","sequence":"additional","affiliation":[{"name":"Bereich Hepatologie, Medizinische Klinik II, Universit\u00e4tsklinikum Leipzig"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Seehofer","sequence":"additional","affiliation":[{"name":"Bereich Hepatologie, Medizinische Klinik II, Universit\u00e4tsklinikum Leipzig"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Berg","sequence":"additional","affiliation":[{"name":"Bereich Hepatologie, Medizinische Klinik II, Universit\u00e4tsklinikum Leipzig"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,8,13]]},"reference":[{"key":"ref1","first-page":"391","article-title":"Deceased donor liver transplantation","volume":"84","author":"D Seehofer","year":"2013","journal-title":"Chirurg"},{"key":"ref3","first-page":"A-175","article-title":"Richtlinien zur Organtransplantation gem. \u00a7 16 TPG","volume":"116","author":"Bundes\u00e4rztekammer","year":"2019","journal-title":"Dtsch \u00c4rztebl Int"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1016\/j.jhep.2017.11.008","article-title":"Potentially inappropriate liver transplantation in the era of the \u201csickest first\u201d policy \u2013 A\u00a0search for the upper 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