It is internationally agreed that a 1-year survival prognosis of less than 90 % is the minimum criterion for listing for LT. The prognosis for acute and chronic liver failure must be juxtaposed with the possible complications and the resulting morbidity and mortality, both in the immediate postoperative and the longer-term course following LT. From the natural course of the liver disease, particularly liver cirrhosis, generally valid prognosis factors can be derived that are decisive for establishing the indication for LT. To do this, suitable patients must be chosen and the timing for the LT indication in the course of the patient’s liver disease must be determined. The goal of LT is to prolong the patients’ lives and improve their quality of life. In patients with acute and chronic liver failure, the indication for LT should be assessed independently of etiology. In Austria between 115 and 150 LT are performed each year (Austrian Federal Institute for Health, Annual Transplant Report Indication The recent assessment of (inter)national LT registers has shown 5‑, 10-, and 15-year survival rates of 75, 65, and 50 %, respectively, with the survival curves and the number of long-term survivors still increasing ( For this reason, LT has for years been deemed an established therapy option with already more than 200,000 transplants performed worldwide. The last 25 years have brought decisive improvements in surgical techniques, postoperative care, immunosuppression, and management of LT patients, so that long-term survivors and the quality of life of transplanted persons have clearly increased. Living liver donations are an alternative and in Austria are performed above all in pediatric patients.īefore the introduction of LT, patients with acute liver failure or decompensated liver cirrhosis had a poor prognosis. Brain death is determined according to a standardized protocol issued by the Austrian Public Health Council (Oberster Sanitätsrat). In Austria, organs for transplantation are largely procured from brain-dead patients. Also, primarily genetic metabolic defects of the liver and the resulting complications can be cured with a liver transplantation (LT). The orthotopic liver transplant (OLT) performed in almost all cases is usually the only curative therapeutic option for patients with acute and chronic liver failure and a hepatocellular carcinoma (HCC). For the evaluation of evidence and the strength of the recommendations, the GRADE system was used (see Table 1 ). The goal of this work is to draw up evidence-based recommendations for establishing the indication for liver transplantation in order to help physicians manage patients who are potential candidates for a liver transplant. For this reason, objective, internationally established and evaluated recommendations for the indication for transplantation and for organ allocation are imperative. For many patients life-saving organs cannot be procured in time. Independent of specific problems involved in the organs to be transplanted, the gap between organs needed and organs available poses a major challenge that has been only partially met over the decades. The success of organ transplantation depends to a large degree on the availability of organs. No other medical procedure provides a comparable improvement in quality of life. We only have one hour to find you if we are unable to locate you, the liver will go the next person on the list.Today, organ transplantation is an internationally established therapy that is indispensable in modern medicine. If we do not have current information, the team may have trouble finding you when it is your turn to receive a transplant. It is a good idea to keep the name and phone number of your transplant coordinator handy so that you can call with any new information. You must notify the team if there has been a change in your address, insurance carrier, phone number, or medical condition. It is extremely important that the transplant team has current information on you. Creatinine, which measures kidney function.INR (prothrombin time), which measures the liver's ability to make blood clotting factors.Bilirubin, which measures how effectively the liver excretes bile.The number is calculated by a formula using three routine lab test results: It gives each individual a score based on how urgently he or she needs a liver transplant within the next three months. The Model for End-Stage Liver Disease (MELD) is a numerical scale, ranging from 6 (less ill) to 40 (gravely ill), that is used for adult liver transplant candidates. The Model for End-Stage Liver Disease (MELD) What is the Model for End-Stage Liver Disease (MELD)? How will it be used?
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