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Lebertransplantation — Indikationen, Vorbereitung und Nachsorge

  • T. Berg
  • R. Pfitzmann
Chapter

Zusammenfassung

Die orthotope Lebertransplantation (OLT) hat die Behandlung der Patienten mit fortgeschrittener terminaler Leberinsuffizienz revolutioniert und ist inzwischen als effektivste Therapie für diese Patienten etabliert. Vor Einführung der Transplantation hatten diese Patienten keine Langzeitüberlebenschancen. Bis zum Jahre 2000 wurden an über 300 Transplantationszentren weltweit mittlerweile mehr als 80.000 Lebertransplantationen durchgeführt. Die derzeitige Frequenz in Deutschland liegt bei ca. 700 Transplantationen/Jahr. Einjahresüberlebensraten von über 90% und Fünfbzw. Zehnjahresüberlebensraten von über 80 bzw. 75% konnten in den letzten Jahren an verschiedenen Transplantationszentren erreicht werden (Abb. 38.1). Zu diesen Erfolgen hat die Verbesserung der immunsuppressiven Therapie durch Einführung von Cyclosporin A, Tacrolimus und monoklonalen Antikörpern, der Organkonservierung, der chirurgischen Technik sowie des perioperativen intensivmedizinischen Managements wesentlich beigetragen. Abbildung 38.2 zeigt weitere Faktoren mit Einfluss auf die Überlebensrate nach OLT.

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© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • T. Berg
  • R. Pfitzmann

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