Lebertransplantation durch Lebendspende

Living related liver transplantation

Zusammenfassung

Die Lebertransplantation ist heute die etablierte Therapie in der Behandlung terminaler Lebererkrankungen. Der Mangel an geeigneten Spenderorganen ist weiterhin der limitierende Faktor dieses Behandlungsverfahrens. Ein Ausweg aus dieser Problematik stellt die Teilorganspende von Gesunden als Lebendspende dar, mit deren Hilfe in einigen Ländern mehr als 90 % der Spenderorgane realisiert werden.

In der Indikationsstellung zur Lebertransplantation gibt es grundsätzlich keinen Unterschied zwischen einer durch eine postmortale oder eine Lebendspende gewonnenes (Teil)Organ. Vor einer Leberlebendspende steht eine gründliche Evaluation des Spenders, um die postoperative Morbidität möglichst zu minimieren. Technisch lehnt sich die Teilleberspende an die onkologische Leberteilresektion an während die Transplantation eine Weiterentwicklung der Split-Lebertransplantation nach postmortaler Organspende darstellt. In spezialisierten Zentren können nach Leberlebendspende inzwischen vergleichbare oder gar bessere Ergebnisse als nach postmortaler Spende erreicht werden.

Abstract

Liver transplantation has become established as a standard procedure in the treatment of end-stage liver diseases. Despite intense efforts by all parties involved up to the amendment of the German Transplantation Act, the lack of suitable donor organs was still one of the limiting factors of this therapeutic procedure. One way out of this problem is to make so-called marginal organs usable, e.g. with the help of machine perfusion or by utilizing living liver donation, which are used in some countries for more than 90% of organ donations. In general, there is no difference in the indications for liver transplantation between a (partial) organ obtained by post-mortem or living donation. Before any living donation, a thorough evaluation of the donor is carried out in order to minimize postoperative morbidity as far as possible. Technically the partial liver donation is based on the oncological liver resection, while the partial liver transplantation is a further development of split liver transplantation after post-mortem liver donation. In specialized centers comparable or even better results can nowadays be achieved using living liver donation instead of post-mortem donation.

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Correspondence to PD Dr. H.-M. Tautenhahn.

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Interessenkonflikt

H.-M. Tautenhahn, F. Rauchfuß, A. Ali Deeb, A. Bauschke und U. Settmacher geben an, dass kein Interessenkonflikt besteht.

Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Dieser Beitrag beinhaltet keine laufenden Studien an Menschen oder Tieren.

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U. Settmacher, Jena

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Tautenhahn, H., Rauchfuß, F., Ali Deeb, A. et al. Lebertransplantation durch Lebendspende. Chirurg (2020). https://doi.org/10.1007/s00104-020-01268-7

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Schlüsselwörter

  • Leberlebendspende
  • Indikation
  • Risiken
  • Outcome
  • Relevanz für Deutschland

Keywords

  • Living liver donation
  • Indication
  • Risk
  • Outcome
  • Relevance for Germany