Liver diseases in the elderly

Durazzo, Marilena; Ponzo, Elena; Bonetto, Silvia; Fagoonee, Sharmila; Pellicano, Rinaldo

doi:10.23736/s0026-4806.18.05858-5

Cited by 24 publications

(15 citation statements)

References 92 publications

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“…This data reveals proportions smaller than expected when compared to previous research on the subject. 11,13,14 Only one of these patients manifested against receiving a xeno-organ. However, as few patients interviewed had emotional problems, it was not possible to establish a relationship between psychological comorbidities and positive perception to xenotransplantation.…”

Section: Discussionmentioning

confidence: 99%

“…However, when it comes to homologous transplants (transplantation between the same species), these data differ from the literature, as it has been shown that some patients believe that liver comorbidity affects their self-esteem and interpersonal relationships, that is, they believe that there is a social stigma in the transplant scenario. 14 When asked about the influence of personal experiences on the acceptance of xenotransplantation, 40 patients (80%) from the TxG and 34 (68%) from the WLP said that everything lived and suffered with the disease helped them to accept the idea of this type of treatment. This association has already been described in the literature when it comes to homologous transplants, demonstrating that there is a notable compromise in the quality of life of patients on the waiting list for liver transplantation, which affects the physical, psychological and social status of the interviewed patients.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Clinical and Psychosocial Factors on the Acceptance of no Human Organs in Transplants: Xenotransplants

Pavan

Godoy

Miyazaki

et al. 2022

BJT

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Introduction: Xenotransplantation is defined as the transplantation of cells, organs and tissues between different species. It is studied as an alternative method to acquire an adequate supply of human organs, which imbalance in demand results in increased mortality on the transplantation waiting list. The aim of the present study was to deepen knowledge about the psychosocial aspects that influence the acceptance or refusal of xenotransplantation, seeking to add information that contributes to patients’ decisions. Methods:A cross-sectional observational study was carried out on reports of the perception of potential recipients of a liver transplant treated at the referral center of a university hospital. Two groups of patients were selected for the study: 50 patients undergoing liver transplantation (transplant group = TxG) and 50 candidates on the waiting list (waiting list group = WLP). All of them were given a questionnaire that addresses the psychosocial aspects that led them to form their opinions about xenotransplantation. To compare the groups, parametric and/or nonparametric tests were used, according to the nature of the data, as well as association tests. Results: Among the interviewees, 91 (91%), being 46% in TxG and 45% in WLP believe that xenotransplants would be beneficial for patients on the waiting list and there was no significant difference between the two groups studied (p = 0.8418); 63 (63%) stated that religion influenced their opinions; 74 (74%) stated that their personal experiences, especially in relation to the suffering generated by their underlying diseases, influenced the way they answered the questionnaire. Conclusions: The acceptance of xenotransplantation is high among the studied groups, and advanced disease and its complications contribute to the acceptance of this treatment modality, both in patients who have already been transplanted and in those who are on the waiting list. Religion had a positive influence in the acceptance of the xeno-organ. None of the measured social and demographic factors scored a p ≤ 0.05 when correlated as a factor for the decision of accepting a xeno-organ. The low number of patients who rejected this technique claimed that lack of information on the subject influenced in their decision. The results gathered indicate a high acceptance of xenografts among the studied groups, and that dissemination of information about xenografts can contribute to increased receptivity to this procedure, furthering its potential as a solution for human organ shortages.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Influence of Clinical and Psychosocial Factors on the Acceptance of no Human Organs in Transplants: Xenotransplants

Pavan

Godoy

Miyazaki

et al. 2022

BJT

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“…Esses dados revelam proporções menores do que o esperado quando comparados a pesquisas anteriores sobre o assunto. 11,13,14 Apenas um desses pacientes se manifestou contra o recebimento de um xeno-órgão. Entretanto, como poucos pacientes entrevistados tinham problemas emocionais, não foi possível estabelecer uma relação entre comorbidades psicológicas e percepção positiva ao xenotransplante.…”

Section: Discussionunclassified

Influência de Fatores Clínicos e Psicossociais na Aceitação de Órgãos não Humanos em Transplantes: Xenotransplantes

Pavan

Godoy

Miyazaki

et al. 2022

BJT

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Introdução: Xenotransplante é definido como o transplante de células, órgãos e tecidos entre diferentes espécies. É estudado como método alternativo para suprimento de órgãos humanos, cujo desequilíbrio na oferta e demanda resulta em alta mortalidade na fila espera de transplantes. O objetivo do presente estudo foi aprofundar o conhecimento sobre os aspectos psicossociais que influenciam na aceitação ou recusa do xeno-órgão, buscando agregar as informações que contribuam para as decisões dos pacientes. Métodos: Foi realizado um estudo observacional transversal a partir de relatos sobre a percepção de potenciais receptores de transplante hepático atendidos no centro de referência de um hospital universitário. Dois grupos de pacientes foram selecionados para o estudo:50 pacientes submetidos a transplante hepático (grupo transplante = TxG) e 50 candidatos a transplante (grupo pacientes em lista de espera = PLE). Todos receberam um questionário que aborda os aspectos psicossociais que os levaram a formar suas opiniões sobre o xenotransplante. Para comparar osgrupos, foram utilizados testes paramétricos e/ou não paramétricos, de acordo com a natureza dos dados, bem como testes de associação. Resultados: Entre os entrevistados, 91 (91%), sendo 46% no TxG e 45% no PLE acreditam que os xenotransplantes seriam benéficos para os pacientes em lista de espera e não houve diferença significativa entre os dois grupos estudados (p = 0,8418); 63 (63%) afirmaram que a religião influenciou suas opiniões; 74 (74%) afirmaram que suas experiências pessoais, principalmente em relação ao sofrimento gerado por suas doenças de base, influenciaram na forma como responderam ao questionário. Conclusão: A aceitação do xenotransplante é alta entre os grupos estudados, e a doença avançada em conjunto com suas complicações contribuem para aaceitação dessa modalidade de tratamento, tanto em pacientes já transplantados quanto naqueles que estão em lista de espera. A religião influenciou positivamente na aceitação do xeno-órgão.Nenhum dos fatores sociais e demográficos medidos obteve p ≤ 0,05, ou seja, relevância estatística, quando correlacionado como um fator para a decisão de aceitar um xeno-órgão. Os poucos pacientes que rejeitaram essa técnica alegaram que a falta de informações sobre o assunto influenciou em suas decisões. Os resultados obtidos indicam uma alta aceitação de xenoenxertos entre os gruposestudados, e que a divulgação de informações sobre os benefícios do xenotransplante pode contribuir para aumentar a receptividade dos pacientes em relação a este procedimento, ampliando seu potencial como solução para a escassez de órgãos humanos.

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“…36,40 Moreover, the aging liver experiences anatomical and physiological changes that increase susceptibility to liver injury and fibrosis, including an altered inflammatory response. 42 The progression of fatty liver disease throughout the human life span coupled with the U.S. obesity epidemic presents a significant public health threat to the health care system.…”

Section: Discussionmentioning

confidence: 99%

Transient elastography assessed hepatic steatosis and fibrosis are associated with body composition in the United States

Ruhl

2020

Preprint

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Background & Aims. We examined transient elastography assessed hepatic steatosis and fibrosis distributions and relationships with body composition in a representative United States population sample. Methods. Liver stiffness and controlled attenuation parameter (CAP) were assessed on 4,870 non-Hispanic white, non-Hispanic black, non-Hispanic Asian, and Hispanic men and women aged 20 years and over in the National Health and Nutrition Examination Survey (NHANES) 2017-2018. Participants underwent anthropometry and dual-energy x-ray absorptiometry (DXA). Results. Compared to women, men had higher mean CAP (274.2 dB/m vs. 254.4 dB/m) and liver stiffness (6.4 kPa vs. 5.5 kPa). CAP and liver stiffness increased with age and BMI. In multivariate-adjusted analysis, CAP in the upper quartile was associated with increased age, BMI, waist-to-hip ratio, ALT and C-reactive protein (p<0.001 for each). After adjustment, non-Hispanic blacks had lower CAP and non-Hispanic Asians had over twice the odds of higher CAP. In multivariate-adjusted analysis, liver stiffness in the upper quartile was associated with male sex, increased age, BMI, GGT, and CAP (p<0.001 for each), and hepatitis C virus positivity. Lower stiffness among Non-Hispanic Asians was not significant after adjustment for BMI. DXA trunk and extremity fat mass were positively related to both CAP and liver stiffness with adjustment for sex, race-ethnicity, and age (p<0.001 for each). Results were similar with CAP and liver stiffness as continuous characteristics. Conclusion. In the U.S. population, increased anthropometric and DXA body composition measures were associated with higher CAP and liver stiffness. Racial-ethnic differences observed merit continuation of NHANES transient elastography to further elucidate the burden of obesity and liver health disparities.

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Liver diseases in the elderly

Cited by 24 publications

References 92 publications

Influence of Clinical and Psychosocial Factors on the Acceptance of no Human Organs in Transplants: Xenotransplants

Influence of Clinical and Psychosocial Factors on the Acceptance of no Human Organs in Transplants: Xenotransplants

Influência de Fatores Clínicos e Psicossociais na Aceitação de Órgãos não Humanos em Transplantes: Xenotransplantes

Transient elastography assessed hepatic steatosis and fibrosis are associated with body composition in the United States

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