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Akutes Leberversagen

Wie viel Diagnostik und Therapie braucht mein Patient?

Acute liver failure

How much diagnostic work-up and therapy does my patient need?

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Zusammenfassung

Das akute Leberversagen ist eine Multisystemerkrankung, die durch eine schwere Leberinsuffizienz mit hepatischer Enzephalopathie gekennzeichnet ist, durch apoptotischen oder nekrotischen Untergang von Leberparenchym verursacht wird und ohne vorbekannte Lebererkrankung auftritt. Die klinische Herausforderung liegt in der frühen Identifizierung von Patienten mit schlechter Prognose und deren rechtzeitiger Listung zur Transplantation. Der vorliegende Beitrag beleuchtet die Grundlagen der Entscheidungsfindung zur Transplantation, aktuelle Aspekte der Intensivtherapie sowie die sklerosierende Cholangitis des Intensivpatienten als Ursache des subakuten Leberversagens.

Abstract

Acute liver failure is a multisystem disease with predominantly sudden and severe hepatic injury and hepatic encephalopathy caused by apoptotic or necrotic hepatocyte damage. The clinical challenge in patients with acute liver failure is to promptly identify those with poor prognosis and refer them for emergency liver transplantation. This review article highlights the main aspects of decision making in the setting of acute liver failure, summarizes new aspects of its critical care management and gives an overview of sclerosing cholangitis in the critically ill patient, an under-recognized disease entity that can progress to acute liver failure.

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  1. Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland

    J. Hadem, A.S. Schneider & M.P. Manns

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  1. J. Hadem
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  3. M.P. Manns
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Hadem, J., Schneider, A. & Manns, M. Akutes Leberversagen. Internist 52, 804–814 (2011). https://doi.org/10.1007/s00108-010-2793-0

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