Zusammenfassung
Seit der ersten klinischen Lebertransplantation im Jahre 1963 durch T.E. Starzl hat sich dieses Verfahren zur Standardtherapie vieler chronischer Lebererkrankungen im Endstadium entwickelt. Durch Optimierung des intra- und perioperativen Managements, durch Fortschritte in der postoperativen immunsuppressiven Therapie und durch verbesserte Möglichkeiten der Organkonservierung konnten während der letzten Jahre die Mortalität und Morbidität nach Lebertransplantation deutlich gesenkt werden. Aufgrund des Spendermangels gewinnen neue Operationstechniken wie die Split-Lebertransplantation sowie die Verwandten-Lebertransplantation zunehmend an Bedeutung.
Grundsätzlich steht die Lebertransplantation auch bei Patienten jenseits des 60. Lebensjahres als Standardtherapieoption zur Verfügung. Durch eine sorgfältige und umfassende Umfelddiagnostik im Rahmen der Evaluation sind die in ausgewählten Diagnosegruppen erzielten Ergebnisse durchaus vergleichbar mit denen jüngerer Transplantationskandidaten.
Abstract
Since the first liver transplantation (OLT) was performed by Starzl in 1963, this has become the standard therapy for end stage chronic liver disease and acute hepatic failure. It is also the therapy of choice in selected cases of hepatic malignancy. Due to the optimization of intra- and perioperative management, new immunosuppressant drugs and improved organ procurement, the clinical outcome in patient and graft survival has increased continuously. The shortage of donor organs has led to the development of new surgical techniques such as split- and living related transplantation. OLT should also be offered to elderly patients. Careful evaluation and patient selection results in good patient and graft survival after transplantation, which is comparable to that in with younger recipients.
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Frühauf, N.R., Frilling, A., Malagó, M. et al. Lebertransplantation bei älteren Patienten. Urologe [A] 43, 942–946 (2004). https://doi.org/10.1007/s00120-004-0639-x
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DOI: https://doi.org/10.1007/s00120-004-0639-x