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World J Gastroenterol. Apr 21, 2019; 25(15): 1817-1827
Published online Apr 21, 2019. doi: 10.3748/wjg.v25.i15.1817
Considerations of elderly factors to manage the complication of liver cirrhosis in elderly patients
Kenya Kamimura, Akira Sakamaki, Hiroteru Kamimura, Toru Setsu, Takeshi Yokoo, Masaaki Takamura, Shuji Terai
Kenya Kamimura, Akira Sakamaki, Hiroteru Kamimura, Toru Setsu, Takeshi Yokoo, Masaaki Takamura, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
Author contributions: Kamimura K and Terai S wrote the manuscript; Sakamaki A, Kamimura H, Setsu T, Yokoo T and Takamura M collected information; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no current financial arrangement or affiliation with any organization that may have a direct influence on their work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Kenya Kamimura, MD, PhD, Lecturer, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan. kenya-k@med.niigata-u.ac.jp
Telephone: +81-25-2272207 Fax: +81-25-2270776
Received: February 25, 2019
Peer-review started: February 25, 2019
First decision: March 5, 2019
Revised: March 12, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: April 21, 2019
Processing time: 53 Days and 6.1 Hours
Abstract

The aging of the organ function causes sensitivity to the disease progression and need careful consideration for the medical treatment. With the increase of aging population, the opportunity to provide medical treatment for people in very old age is rapidly increasing therefore, the understanding of the various physiological changes of cellular function, size and function of organs are essential for the decision of therapeutic options. Among the various chronic conditions seen in elderly people, we have focused on liver cirrhosis, since despite specific therapeutic options for many of liver diseases including direct acting antivirals for hepatitis C virus, nucleoside analogs for hepatitis B, and corticosteroids for autoimmune hepatitis, there is currently no standard therapy to treat liver cirrhosis, which is the final stage of these liver diseases. Therefore, management of the various symptoms of liver cirrhosis is essential, and aging-related parameters must be considered in the decision making for therapeutic strategies and dosage of the available medicine. In this mini-review, we have summarized the therapeutic options to manage various symptoms of liver cirrhosis, carefully considering the physiological changes of various organs associated with aging.

Keywords: Liver cirrhosis; Elderly patients; Quality of life; Aging

Core tip: The increasing aging population is a worldwide issue and societies are facing various problems including long-term care for populations with a high prevalence of chronic conditions including the liver diseases. It is clear that management of hepatitis and cirrhosis is important to maintain hepatic function as well as activities of daily living and quality of life of liver disease patients. While various therapeutic options have been available including newly developed medicines and techniques, the aging-related parameters must be considered in the decision making for therapeutic strategies and dosage of the available medicine. However, as there is no information available to date in this field, to fill this gap, we have summarized the points that must be considered upon the management of liver cirrhosis in elderly patients. The information summarized will be helpful for physicians treating the elderly patients with the understanding of the aging-related changes of the body and organs.