부산대학교 도서관

Summary: Aging involves a number of changes in hepatic morphology and function that can lead to a decrease in resistance to pathogenic noxae and to an inferior regenerative capacity. No one biomarker can be directly related to an exact influence of aging on the hepatic structure. In the elderly, the most frequent chronic hepatopathies are hepatitis C, disease due to alcohol, chronic fatty hepatopathy and hepatocarcinoma. Drugs can cause hepatocellular, cholestatic or mixed damage, which reveals itself as an “acute hepatitis”, or sometimes can overlap with a previous chronic hepatopathy, worsening the prognosis. Available therapies are similar to those for younger people, but with careful attention to side effects which are often more serious in the elderly. Hepatocarcinoma represents a challenge for hepatologists, because frequently the most effective therapies, such as resection and transplant, are contraindicated because of the associated comorbidities: an accurate risk-benefit evaluation becomes necessary. A comprehensive and global evaluation of the elderly patient (clinical, cognitive/functional and in terms of social care) will support a more accurate prognosis than a simple liver evaluation score.