Lebertransplantationen bei autoimmunen Lebererkrankungen

Cirrhosis due to autoimmune liver disease is an indication for liver transplantation. In Eurotransplant countries, the model for end-stage liver disease (MELD) score was introduced in December 2006. The lab-MELD is based on creatinine, bilirubin, and prothrombin time expressed as the international normalized ratio (INR). If patients with primary sclerosing cholangitis develop complications, such as biliary sepsis, standard exceptional criteria (match-MELD) might be added to increase the priority of organ allocation. Because of excellent short-term outcomes after liver transplantation, attention has shifted to improving long-term survival and particularly to treating recurrent disease. Diagnosis of disease relapse in autoimmune and cholestatic liver disease is more challenging than in the non-transplant setting. However, despite limited therapeutic options for recurrent autoimmune liver disease after transplantation, affected patients exhibit excellent long-term survival.