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Ätiologiebedingte Therapieoptionen für das akute Leberversagen

Etiology-dependent therapy options for acute liver failure

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Zusammenfassung

Ein akutes Leberversagen (ALV) kann durch diverse Ursachen ausgelöst werden. Für das klinische Management dieser lebensbedrohlichen Situation ist es unabdingbar, die zugrunde liegende Ursache zu identifizieren. Abhängig von der Ätiologie des ALV variieren Verlauf und Prognose dieser Erkrankung. Aber auch die verfügbaren spezifischen Therapieansätze variieren je nach Ätiologie und Zeitpunkt der Erkennung. Ein wachsendes Verständnis der zellulären und molekularen Prozesse beim ALV ermöglichen bei bestimmten Ätiologien bereits eine gute Versorgung und in einigen Fällen die Vermeidung einer orthotopen Lebertransplantation oder eines letalen Ausgangs. Sofern verfügbar sollten daher immer konservative Methoden ausgeschöpft werden. Bei vielen Patienten bleibt die Transplantation jedoch die einzige Behandlungsoption. In diesen Fällen sollte eine schnelle Listung mit hoher Priorität erfolgen.

Abstract

Acute liver failure (ALF) can be induced by a variety of causes. For clinical management of this life-threatening disease, early identification of the underlying cause is crucial. Depending on the etiology, the course and prognosis of ALF may differ to a great extent. Specific therapy options also vary depending on the etiology and time of diagnosis. A slowly increasing knowledge of the cellular and molecular processes in ALF already allows avoidance of orthotopic liver transplantation or fatal outcome in selected etiologies. If available, conservative methods for treatment should be exploited to maximum effect; however, for some etiologies of ALF transplantation remains the only therapy. In these cases, a timely registration for transplantation should be given high priority.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A. Canbay gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Deutschland

    A. Canbay & G. Gerken

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  1. A. Canbay
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  2. G. Gerken
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Correspondence to A. Canbay.

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Canbay, A., Gerken, G. Ätiologiebedingte Therapieoptionen für das akute Leberversagen. Gastroenterologe 9, 55–65 (2014). https://doi.org/10.1007/s11377-013-0814-y

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  • DOI: https://doi.org/10.1007/s11377-013-0814-y

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