Update on liver transplantation-newer aspects
| Autor: | Olga Metin, Ahmet Gurakar, Cem Simsek |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Alcoholic liver disease Tissue and Organ Procurement media_common.quotation_subject medicine.medical_treatment Alcoholic hepatitis HIV Infections 030204 cardiovascular system & hematology Liver transplantation Article End Stage Liver Disease marginal liver grafts 03 medical and health sciences Liver disease Extended criteria donor 0302 clinical medicine medicine Humans Obesity Intensive care medicine media_common 0303 health sciences liver transplantation Hepatitis Alcoholic 030306 microbiology Donor selection business.industry Gold standard Age Factors General Medicine Abstinence medicine.disease severe alcoholic hepatitis Tissue Donors business Simple fact |
| Zdroj: | Turkish Journal of Medical Sciences |
| ISSN: | 1303-6165 |
| DOI: | 10.3906/sag-2002-17 |
| Popis: | Liver transplantation (LT) remains the only therapeutic option offering gold standard treatment for end-stage liver disease (ESLD) and acute liver failure (ALF), as well as for certain early-stage liver tumors. Currently, the greatest challenge facing LT is the simple fact that there are not enough adequate livers for all the potential patients that could benefit from LT. Despite efforts to expand the donor pool to include living and deceased donors, organ shortage is still a major problem in many countries. To solve this problem, the use of marginal liver grafts has become an inevitable choice. Although the definition of marginal grafts or criteria for expanded donor selection has not been clarified yet, they are usually defined as grafts that may potentially cause primary nonfunction, impaired function, or late loss of function. These include steatotic livers, older donors, donors with positive viral serology, split livers, and donation after cardiac death (DCD). Therefore, to get the best outcome from these liver grafts, donor-recipient selection should be vigilant. Alcohol- related liver disease (ALD) is one of the most common indications for LT in Europe and North America. Traditionally, LT for alcoholic liver disease was kept limited for patients who have achieved 6 months of abstinence, in part due to social and ethical concerns regarding the use of a limited resource. However, the majority of patients with severe alcoholic hepatitis who fail medical therapy will not live long enough to meet this requirement. Besides, the initial results of early liver transplantation (ELT) without waiting for 6 months of abstinence period are satisfactory in severe alcoholic hepatitis (SAH). It will be important to take care of these patients from a newer perspective. |
| Databáze: | OpenAIRE |
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