Die orthotope Lebertransplantation als lebensrettende therapeutische Maβnahme für Patienten mit chronisch progredienter posthepatitischer Lebererkrankung ist lange kontrovers diskutiert worden, da die Reinfektion des Transplantates unter immunosuppressiver Therapie zur schweren Hepatitis führen kann. Seit der Einfiihrung der passiven Immunprophylaxe zur Vermeidung der Transplantat-Reinfektion mit dem Hepatitis-B-Virus konnten die Überlebensraten deutlich verbessert werden. Anhand der eigenen Ergebnisse bei 531 Transplantationen im Zeitraum von September 1988 bis August 1994 werden die Kurz- und Langzeitergebnisse der Lebertransplantation bei Patienten mit Hepatitis-B- und -C-Zirrhose mit denen von Patienten mit alkoholtoxischer Zirrhose verglichen und die Problematik und Möglichkeiten der Verhinderung der Transplantat-Reinfektion diskutiert.

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