[Liver transplantation - when and for whom it should be performed]

Morell, Bernhard; Dufour, Jean-François (2011). [Liver transplantation - when and for whom it should be performed]. Therapeutische Umschau, 68(12), pp. 707-13. Bern: Huber 10.1024/0040-5930/a000234

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During the past two decades, orthotopic liver transplantation (OLT) emerged to the treatment of choice for patients with end-stage liver disease. In Switzerland, about 100 liver transplantations are performed every year, while the shortage of cadaveric organs considerably outmatches the demand. Common indications for OLT include cirrhosis due to alcoholic liver disease or chronic viral hepatitis related to hepatitis B or C, and hepatocellular carcinoma. With the advent of the new allocation policy in Switzerland in 2007, patients listed for OLT are mainly stratified based on the Model of End-stage Liver Disease (MELD) score. Using a patient's laboratory values for serum bilirubin, serum creatinin, and the international normalized ratio for prothrombin time (INR), the MELD score accurately predicts three-month mortality among patients on the waiting list. Compared to the pre-MELD era, patients with significantly higher MELD scores undergo transplantation which leads in turn to more complications and higher costs yet with a comparable outcome. Timely referral of potential candidates to a transplant center is crucial since thorough evaluation to rule out contraindications such as uncontrolled infection, extrahepatic malignancy or advanced cardiopulmonary disease is essential. Taken together, every patient presenting with acute liver failure, decompensated cirrhosis or suspected hepatocellular carcinoma should be evaluated in a center with liver transplantation capability.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

Dufour, Jean-François

ISSN:

0040-5930

Publisher:

Huber

Language:

German

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:22

Last Modified:

06 Dec 2013 13:28

Publisher DOI:

10.1024/0040-5930/a000234

PubMed ID:

22139986

URI:

https://boris.unibe.ch/id/eprint/7715 (FactScience: 213041)

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