Das Management von Patienten mit akutem Leberversagen und von anderen Notfallsituationen erfordert ein hohes Maβ an klinischer Erfahrung und interdisziplinärer Zusammenarbeit. Entscheidend für die Gesamtprognose sind neben Ätiologie und aktuellem Zustand die Beurteilung des Spontanverlaufs. Danach richtet sich im wesentlichen die Indikationsstellung zur Behandlung. Beim fortgeschrittenen Leberversagen ist die orthotope Lebertransplantation die Therapie der Wahl mit insgesamt guten Erfolgsaussichten. Alternative Verfahren wie Hepatektomie mit temporärem portokavalem Shunt, auxiliäre Transplantation oder extrakoporale Unterstützungssysteme sind bislang extremen Notfallsituationen vorbehalten oder können als Überbrückung in besonders erfahrenen Zentren dienen. Der routinemäβige Einsatz dieser innovativen Methoden wird allerdings erst in Zukunft zu erwarten sein.

Keywords:
Lebertransplantation, Notfallindikationen, «Bridging»
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© 1994 S. Karger AG, Basel
1994
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