Abstract
The introduction of MELD-based liver allocation in the Eurotransplant region in December 2007 has reduced waiting list mortality. However, it resulted in a significant reduction of posttransplant survival rate in Germany. The main reason for this development is the dramatic donor organ shortage in Germany. Nowadays, regular liver allocation is not realistic below a (lab)MELD score of 35. These patients are very often ICU-bound and requiring catecholamines and renal replacement therapy, which explains the limited prognosis after liver transplantation. Increasing organ availability seems to be vital to ease the situation on the waiting list. The increasing use of so-called "marginal liver allograftso" and living donor liver transplants are widely discussed in this context. Furthermore, improvements in selecting adequate liver recipients with MELD > 30 and immunosuppressive regimens are further cornerstone to optimize prognosis in this special subset of patients.
| Translated title of the contribution | Liver transplantation in time of MELD - Implications for Germany |
|---|---|
| Original language | German |
| Pages (from-to) | 304-308 |
| Number of pages | 5 |
| Journal | Klinikarzt |
| Volume | 41 |
| Issue number | 6-7 |
| DOIs | |
| State | Published - 2012 |