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Aging and the liver: an update

D L Schmucker1

  • 1Cell Biology and Aging Section, San Francisco Department of Veterans Affairs Medical Center, USA. SCHMUCKER.DOUGLAS_L@SANFRANCISCO.VA.GOV

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|October 1, 1998
PubMed
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Liver function in the elderly is complex, with some age-related structural changes but generally well-maintained function. Clinical outcomes suggest age alone shouldn't dictate liver disease treatment decisions.

Area of Science:

  • Gerontology
  • Hepatology
  • Pharmacology

Background:

  • The impact of aging on liver function remains debated, with conflicting data on structural and functional changes.
  • Reported age-related hepatic alterations include changes in hepatocyte size, binucleation, mitochondria, and endoplasmic reticulum, though quantitative data are often contradictory.

Purpose of the Study:

  • To critically evaluate the evidence regarding age-related changes in liver structure and function.
  • To assess the clinical implications of these changes for geriatric patients, particularly concerning drug metabolism and surgical interventions.

Main Methods:

  • Review of existing literature on age-related hepatic structural and functional modifications.
  • Analysis of functional data, including drug clearance, liver regeneration, and clinical outcomes in elderly populations.

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Main Results:

  • Quantitative morphological studies often refute qualitative observations of age-related structural changes.
  • Elderly individuals show decreased hepatic drug clearance and increased adverse drug reactions, linked to reduced liver volume and blood flow, not necessarily impaired metabolism.
  • While liver regeneration rate declines, overall regenerative capacity is maintained, suggesting reduced responsiveness to hepatotrophic factors.

Conclusions:

  • Despite some age-associated declines in adaptive responsiveness and reserve capacity, overall liver function is generally well-maintained in the elderly.
  • Age alone should not be a primary factor in clinical decisions regarding liver surgery or transplantation.
  • Understanding age-related changes is crucial for managing polypharmacy and optimizing treatment in geriatric patients.