[Centralisation of Liver Transplantation: Implications for Training Transplant Surgeons]

The centralisation of liver transplantation in Germany is seen as a promising approach to improve care quality through higher case volumes and specialised structures. However, it poses significant challenges for surgical training. Reduced availability of training positions, limited diversity of clinical experience, and the risk of capacity bottlenecks could impact the education of young transplant surgeons in the long term. This article explores the opportunities and risks of centralisation, particularly regarding surgical education. While higher case volumes are associated with better outcomes, it is argued that complementary measures such as regional support structures, rotation programs, and, where applicable, the use of practical training models are essential to ensure comprehensive education. The implementation of regulations of minimum case volume is also discussed as a potential regulatory tool. Finally, the article highlights the need for future studies to systematically evaluate the impact of centralisation on surgical education and to provide an evidence-based foundation for decision making.