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Z Gastroenterol 2024; 62(01): 62-72
DOI: 10.1055/a-2226-0123
Übersicht

Liver transplantation meets gastrointestinal cancer

Lebertransplantation bei gastrointestinalen Tumoren
Sven H. Loosen 
1   Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany (Ringgold ID: RIN39064)
2   Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
,
Catherine Leyh
1   Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany (Ringgold ID: RIN39064)
2   Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
,
Ulf Peter Neumann
3   Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Aachen, Germany
4   Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany
,
Hans Bock
1   Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany (Ringgold ID: RIN39064)
2   Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
,
Christian Weigel
2   Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
1   Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany (Ringgold ID: RIN39064)
,
Tom Luedde 
1   Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany (Ringgold ID: RIN39064)
2   Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
,
Christoph Roderburg
1   Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany (Ringgold ID: RIN39064)
2   Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
› Author AffiliationsFunding in the group of TL was provided by: The European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (Grant agreement No. 771083); the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation): 403224013, 279874820, 461704932, 440603844; and the Federal Ministry of Health (BMG): 2520DAT111 (DeepLiver). CL receives funding by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation): 493659010
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Abstract

Liver transplantation (LT) has emerged as a standard of care for patients with end-stage liver disease, providing a life-saving intervention for patients with severely compromised liver function in both the acute and chronic setting. While LT has also become a routine procedure for early-stage hepatocellular carcinoma (HCC), offering a potential cure by treating both the tumor and the underlying liver disease, its relevance in the context of other malignancies such as cholangiocellular carcinoma (CCA), combined hepatocellular-cholangiocarcinoma (cHCC-CCA) or liver metastases is still the subject of intense debate and no definite recommendations have yet been established. This review summarizes the current therapeutic standards in the context of LT for gastrointestinal malignancies and provides a reflection and outlook on current scientific and clinical developments.

Zusammenfassung

Die Lebertransplantation (LT) hat sich als Standardbehandlung für Patienten mit Lebererkrankungen im Endstadium etabliert und stellt sowohl im akuten als auch im chronischen Stadium einen lebensrettenden Eingriff für Patienten mit stark eingeschränkter Leberfunktion dar. Während die Lebertransplantation auch für das hepatozelluläre Karzinom (HCC) im Frühstadium zu einem Routineverfahren geworden ist und eine potenzielle Heilung bietet, indem sowohl der Tumor als auch die zugrunde liegende Lebererkrankung behandelt werden, wird ihre Relevanz im Zusammenhang mit anderen bösartigen Erkrankungen wie dem cholangiozellulären Karzinom (CCA), dem kombinierten hepatozellulären/cholangiozellulären Karzinom (cHCC-CCA) oder Lebermetastasen noch immer intensiv diskutiert, und es gibt noch keine definitiven Empfehlungen. Diese Übersicht fasst die aktuellen Therapiestandards im Rahmen der LT bei gastrointestinalen Malignomen zusammen und gibt einen Überblick über und Ausblick auf die aktuellen wissenschaftlichen und klinischen Entwicklungen.

Keywords

HCC - CCA - cHCC/CCA - MELD - Eurotransplant - liver transplantation

Schlüsselwörter

HCC - CCC - cHCC/CCC - MELD - Eurotransplant - Lebertransplantation


Publication History

Received: 17 September 2023

Accepted after revision: 11 December 2023

Article published online:
09 January 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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