Liječnički vjesnik, Vol. 142 No. 7-8, 2020.
Original scientific paper
https://doi.org/10.26800/LV-142-7-8-34
Long-term care for a patient following liver transplantation from a perspective of a family physician
Anna Mrzljak
; Klinika za unutarnje bolesti, Medicinski fakultet Sveučilišta u Zagrebu, Klinička bolnica Merkur, Zagreb; Medicinski fakultet Sveučilišta u Zagrebu
Ana Jelić
; Klinika za unutarnje bolesti, Medicinski fakultet Sveučilišta u Zagrebu, Klinička bolnica Merkur, Zagreb
Lucija Franušić
; Medicinski fakultet Sveučilišta u Zagrebu
Robert Likić
; Klinika za unutarnje bolesti, Medicinski fakultet Sveučilišta u Zagrebu, Klinički bolnički centar Zagreb
Zlata Ožvačić Adžić
; Škola narodnog zdravlja „Andrija Štampar“, Medicinski fakultet Sveučilišta u Zagrebu;Dom zdravlja Zagreb – Centar
Abstract
Croatia is among the leading countries in the world according to the liver transplants rates. Owing to the longer post-transplant survival, the need for long-term care for patients is increasing, with an increasing proportion of care being provided by family physicians. Late complications after liver transplantation include a wide range of metabolic disorders that occur in a significant percentage of patients: diabetes (up to 30%), dyslipidemia (45–69%), hypertension (50–90%), obesity (up to 40%), osteoporosis (37%), hyperuricemia (14– 47%), while the occurrence of certain malignant diseases remains up to four times higher than in the non-transplant population. Cardiovascular disease and malignancies are the leading causes of long-term mortality following liver transplantation. In addition to other risk factors, immunosuppressive drugs: calcineurin inhibitors, antimetabolites
and mTOR inhibitors contribute significantly to the development of these complications. Furthermore, in 22–33% of patients after liver transplantation, some form of mood disorder develops, most commonly anxiety and depression. Prevention, recognition, and management of complications after liver transplantation are the key to improving long-term outcomes. The aim of this review paper is to address the issue of long-term care for patients after liver transplantation in primary care.
Keywords
LIVER TRANSPLANTATION – adverse effects; PHYSICIANS, FAMILY; IMMUNOSUPPRESSIVE AGENTS – adverse effects, therapeutic use; METABOLIC SYNDROMES – etiology; CARDIOVASCULAR DISEASES – etiology; NEOPLASMS – etiology; RISK FACTORS; POSTOPERATIVE COMPLICATIONS – prevention and control; PRIMARY HEALTH CARE – methods
Hrčak ID:
243277
URI
Publication date:
24.8.2020.
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