Extracorporeal liver support therapies (ELS) are technical options (for bridge-to-recovery as well as bridge-to-transplant) in patients with acute liver dysfunction (e.g. acute liver failure (ALF), acute-on chronic liver failure (AoCLF) or decompensated chronic liver disease (decomp. CLD)) to reduce effects of failing hepatic detoxification functions. The present study investigates the real-life utilization of ELS (annual incidences), mortality rates as well as data regarding specific populations of liver transplantation in Germany. Data on patient cases receiving extracorporeal liver support therapy were identified in a nationwide data set from the Federal statistical Office of Germany from 1 January 2007 through 31 December 2015 and analyzed regarding in-hospital mortality, age- and sex-specific distribution and use of ELS in the context of liver transplantation. Mortality rates in patients with primary acute liver dysfunction and secondary acute liver dysfunction (in the context of cardiothoracic surgery) were evaluated. Annual incidences of ELS use remained stable between 0.39/100.000 in 2007 and 0.47/100.000 ELS in 2015. In-hospital mortality rate was 51.49% in the 2886 evaluated patient cases. Mortality was higher in men (56.04%) than in women (43.70) in the observed time period between 2007 and 2015. ELS utilization and case-related liver transplantation rates were low (12.47%). Since 2012, the annual numbers for ELS therapy in cardiosurgical patients exceeded the frequency of ELS utilization in cases of primary liver dysfunction (mortality rates: 68.39% versus 40.63%). ELS utilization remained stable between 2007 and 2015. Mortality rates are high in this patient population of acute liver dysfunction, especially in combination with case-related cardiothoracic surgery. ELS is rarely used in the setting of liver transplantation. In 2015, more than 50% of all ELS cases in Germany were performed in the context of cardiothoracic surgery.

中文翻译：

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体外肝支持：流行病学和死亡率趋势-全国数据库分析2007–2015

对于患有急性肝功能不全（例如急性肝衰竭（ALF），急性上慢性肝衰竭（AoCLF））的患者，体外肝支持疗法（ELS）是技术选择（用于桥接至恢复以及桥接至移植）或失代偿性慢性肝病（decomp。CLD）），以减轻肝脏排毒功能衰竭的影响。本研究调查了德国ELS的实际利用率（年发病率），死亡率以及有关肝移植特定人群的数据。从2007年1月1日至2015年12月31日，德国联邦统计局在全国范围内收集了接受体外肝支持治疗的患者病例数据，并进行了院内死亡率分析，年龄和性别的特定分布以及在肝移植中使用ELS的情况。评估了原发性急性肝功能不全和继发性急性肝功能不全（在心胸外科手术中）患者的死亡率。使用ELS的年发生率在2007年的0.39 / 100.000和2015年的0.47 / 100.000之间保持稳定。在评估的2886例患者中，住院死亡率为51.49％。在2007年至2015年的观察时间段内，男性的死亡率较高（56.04％），女性的死亡率较高（43.70）。ELS利用率和病例相关肝移植率较低（12.47％）。自2012年以来，在原发性肝功能不全患者中，每年在心脏外科手术患者中进行ELS治疗的次数超过了ELS的使用频率（死亡率：68.39％对40.63％）。在2007年至2015年之间，ELS的使用率保持稳定。在此急性肝功能不全患者群体中，死亡率很高，尤其是与病例相关的心胸外科手术相结合。ELS很少用于肝移植。2015年，德国所有ELS病例中有50％以上是在心胸外科手术中进行的。