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Ageing and hepatic function 

Ageing and hepatic function
Chapter:
Ageing and hepatic function
Author(s):

James M. Prentis

and Chris. P. Snowden

DOI:
10.1093/med/9780199604999.003.0009
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date: 18 August 2019

This chapter reviews the relevant anatomy and physiology of the liver and then describes the changes with ageing and the impact this has on susceptibility to liver disease. Gross changes are not apparent, but microvascular changes in sinusoidal epithelium and endothelial thickening are described. Kupffer and stellate cells’ function with ageing and their potential clinical impact are reviewed. Hepatic regeneration is impaired and the possible mechanisms are identified, including lipofuscin, telomere shortening, and the response to growth factors. Age-related changes in function are identified before a review of liver diseases, including non-alcoholic fatty and alcoholic liver disease. Hepatitis C and hepatocellular carcinoma are also covered. Finally, the liver’s role in sepsis and the anaesthetic considerations for liver resection and transplantation are described.

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