{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:06:24Z","timestamp":1777496784640,"version":"3.51.4"},"reference-count":70,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die Lebertransplantation ist die einzige kurative Therapieoption einer chronischen Leberinsuffizienz im Endstadium. Daneben stellen onkologische Lebererkrankungen wie das HCC eine weitere\n          Indikation f\u00fcr die Lebertransplantation dar, ebenso wie das akute Leberversagen.<\/jats:p><jats:p>Seit der ersten erfolgreichen Lebertransplantation durch Professor Thomas E. Starzl im Jahr 1967 haben sich nicht nur die chirurgischen, immunologischen und an\u00e4sthesiologischen Techniken\n          und M\u00f6glichkeiten ge\u00e4ndert, sondern auch die Indikationen und das Patientengut. Hinzu kommt, dass die Empf\u00e4nger ein zunehmendes Lebensalter und damit einhergehend mehr Begleiterkrankungen\n          aufweisen.<\/jats:p><jats:p>Die Zahl an Lebertransplantationen ist weltweit weiter ansteigend. Es ben\u00f6tigen aber mehr Menschen eine Lebertransplantation, als Organe zur Verf\u00fcgung stehen. Dies liegt am zunehmenden\n          Bedarf an Spenderorganen bei gleichzeitig weiter r\u00fcckl\u00e4ufiger Zahl postmortaler Organspenden.<\/jats:p><jats:p>Diese Diskrepanz zwischen Spenderorganen und Empf\u00e4ngern kann nur zu einem kleinen Teil durch Split-Lebertransplantationen oder die Leberlebendspende kompensiert werden.<\/jats:p><jats:p>Um den Spenderpool zu erweitern, werden zunehmend auch marginale Organe, die nur die erweiterten Spenderkriterien (\u201eextended donor criteria [EDC]\u201c) erf\u00fcllen, allokiert. In manchen L\u00e4ndern\n          z\u00e4hlen hierzu auch die sogenannten DCD-Organe (DCD: \u201edonation after cardiac death\u201c), d.\u00a0h. Organe, die erst nach dem kardiozirkulatorischen Tod des Spenders entnommen werden.<\/jats:p><jats:p>Es ist bekannt, dass marginale Spenderorgane mit einem erh\u00f6hten Risiko f\u00fcr ein schlechteres Transplantat- und Patienten\u00fcberleben nach Lebertransplantation einhergehen.<\/jats:p><jats:p>Um die Qualit\u00e4t marginaler Spenderorgane zu verbessern, hat sich eine rasante Entwicklung der Techniken der Organkonservierung \u00fcber die letzten Jahre gezeigt. Mit der maschinellen\n          Organperfusion besteht beispielsweise die M\u00f6glichkeit, die Organqualit\u00e4t deutlich zu verbessern. Insgesamt haben sich die Risikokonstellationen von Spenderorgan und Transplantatempf\u00e4nger\n          deutlich ge\u00e4ndert.<\/jats:p><jats:p>Aus diesem Grunde ist es von gro\u00dfer Bedeutung, spezifische Pr\u00e4diktoren f\u00fcr eine erfolgreiche Lebertransplantation sowie die entsprechenden Risikofaktoren f\u00fcr einen schlechten postoperativen\n          Verlauf zu kennen, um das bestm\u00f6gliche Transplantat- und Patienten\u00fcberleben nach Lebertransplantation zu erm\u00f6glichen.<\/jats:p><jats:p>Diese Einflussfaktoren, inklusive m\u00f6glicher Risiko-Scores, sollen hier ebenso wie die neuen technischen M\u00f6glichkeiten in der Lebertransplantation beleuchtet werden.<\/jats:p>","DOI":"10.1055\/a-1866-4197","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T22:44:48Z","timestamp":1658443488000},"page":"369-380","source":"Crossref","is-referenced-by-count":4,"title":["Pr\u00e4diktoren f\u00fcr erfolgreiche Lebertransplantationen und Risikofaktoren"],"prefix":"10.1055","volume":"147","author":[{"given":"Carina","family":"Riediger","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Thorax-, und Gef\u00e4\u00dfchirurgie, Technische Universit\u00e4t Dresden, Dresden, Deutschland"},{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Thorax-, und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Schweipert","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Thorax-, und Gef\u00e4\u00dfchirurgie, Technische Universit\u00e4t Dresden, Dresden, Deutschland"},{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Thorax-, und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Weitz","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Thorax-, und Gef\u00e4\u00dfchirurgie, Technische Universit\u00e4t Dresden, Dresden, Deutschland"},{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Thorax-, und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,7,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1016\/S1473-3099(16)00052-9","article-title":"Ledipasvir and sofosbuvir plus ribavirin in patients with genotype 1 or 4 hepatitis C virus infection and advanced liver disease: a multicentre, open-label, randomised, phase 2 trial","volume":"16","author":"M Manns","year":"2016","journal-title":"Lancet Infect 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