Dugoročna skrb za pacijenta nakon transplantacije jetre iz perspektive obiteljskog liječnika

Scientific paper - Original scientific paper

• Title (english): Long-term care for a patient following liver transplantation from a perspective of a family physician
• Author: Anna Mrzljak
• Author: Ana Jelić
• Author: Lucija Franušić
• Author: Robert Likić
• Author: Zlata Ožvačić Adžić
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (croatian)

Hrvatska je među vodećim zemljama u svijetu po stopi transplantacija jetre. Zahvaljujući sve dužem
preživljenju nakon transplantacije povećana je potreba za dugoročnom skrbi pacijenata, pri čemu sve veći dio skrbi
preuzimaju obiteljski liječnici. Kasne komplikacije transplantacije jetre uključuju širok spektar metaboličkih poremećaja
koji se javljaju u značajnom postotoku transplantiranih; šećerna bolest (do 30%), dislipidemija (45 –
69%), hipertenzija (50 – 90%), pretilost (do 40%), osteoporoza (37%), hiperuricemija (14 – 47%), dok je
pojava pojedinih malignih bolesti i do 4 puta viša nego u netransplantiranoj populaciji. Kardiovaskularne bolesti i
malignomi vodeći su uzroci smrtnosti dugoročno nakon transplantacije jetre. Uz ostale faktore rizika, imunosupresivni
lijekovi, kalcijneurinski inhibitori, antimetaboliti i mTOR inhibitori značajno pridonose razvitku navedenih
komplikacija. Nadalje, kod 22 – 33% pacijenata nakon transplantacije jetre prisutan je neki oblik poremećaja
raspoloženja, od kojih najčešće anksioznost i depresija. Prevencija, prepoznavanje i zbrinjavanje komplikacija
nakon transplantacije jetre ključni su za poboljšanje dugoročnih ishoda. Cilj ovog preglednog rada jest približiti
problematiku dugoročnog zbrinjavanja pacijenata nakon transplantacije jetre u primarnoj zdravstvenoj zaštiti.

Abstract (english)

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 (croatian): TRANSPLANTACIJA JETRE – komplikacije; OBITELJSKI LIJEČNIK; IMUNOSUPRESIVNI LIJEKOVI –nuspojave, terapijska uporaba; METABOLIČKI SINDROM – etiologija; KARDIOVASKULARNE BOLESTI – etiologija; TUMORI – etiologija; RIZIČNI ČIMBENICI; POSLIJEOPERACIJSKE KOMPLIKACIJE – prevencija; PRIMARNA ZDRAVSTVENA ZAŠTITA – metode
• Keywords (english): 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
• Language: croatian
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Liječnički vjesnik
• Numbering: vol. 142, no. 7-8, pp. 204-214
• p-ISSN: 0024-3477
• e-ISSN: 1849-2177
• DOI: https://doi.org/10.26800/LV-142-7-8-34
• URN:NBN: urn:nbn:hr:105:027750
• Publication: 2020
• Document URL: https://hrcak.srce.hr/index.php?show=clanak&id_clanak_jezik=353556
• Type of resource: Text
• Access conditions: Open access
• Created on: 2020-11-26 11:44:29