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Die Anaesthesiologie
Erschienen in: Die Anaesthesiologie 6/2019

02.05.2019 | Hepatozelluläres Karzinom | CME

Anästhesiologische Aspekte bei der Lebertransplantation

verfasst von: S. Dehne, F. Lund, J. Larmann, K. Schmidt, T. Brenner, M. A. Weigand, R. von Haken

Erschienen in: Die Anaesthesiologie | Ausgabe 6/2019

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Zusammenfassung

Die Lebertransplantation (LTPL) ist für Patienten mit terminaler Leberinsuffizienz oder einem hepatozellulären Karzinom (HCC) die einzige kurative Option. Die Organverteilung erfolgt über Eurotransplant in Leiden, Niederlande. Für die Allokation ist der „Model of End-stage Liver Disease (MELD) Score“ wesentlich, der die Schwere der Lebererkrankung abbildet. Das heterogene Patientenkollektiv sowie hepatisch bedingte Komorbiditäten und ihre Dynamik stellen Herausforderungen dar. Dem Anästhesisten kommt die wichtige Aufgabe einer Einschätzung der Gesamtprognose zu; hierbei sind kardiale, pulmonale, renale und neurologische Komorbiditäten zu berücksichtigen. Operativ unterteilt sich die LTPL in mehrere Phasen. Für den Anästhesisten stellen neben dem Volumen‑, Wärme- und Gerinnungsmanagement häufig die kardiozirkulatorische Stabilisierung sowie der Ausgleich des Säure-Basen-Haushaltes wesentliche Aufgaben dar.
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Metadaten
Titel
Anästhesiologische Aspekte bei der Lebertransplantation
verfasst von
S. Dehne
F. Lund
J. Larmann
K. Schmidt
T. Brenner
M. A. Weigand
R. von Haken
Publikationsdatum
02.05.2019

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