Effects of systemic chemotherapy on the liver
Journal Title: Annals of Hepatology - Year 2010, Vol 9, Issue 2
Abstract
The liver is the largest parenchymatous organ of the body and central for intermediate metabolism. Its close contact to the portal blood streaming back from the gut and the systemic circulation is a prerequisite for the various processes ongoing on cellular level. The spatial relationship of the hepatocytes with the different cellular structures of the liver, such as fenestrated sinusoidal endothelial cells, Kupffer cells, and bile canaliculi is important for the organization and performance of the intermediate metabolism of nutrients (proteins, glucose and fatty acids), for the clearance of toxic or infectious agents, for metabolic detoxification and for the excretion of waste products. The administration of chemotherapy is a challenge for the tight regulation and balance of these processes. As most drugs tend to be lipophilic, they are readily taken up by the liver. Under chemotherapy, up to 85% of patients develop liver steatosis. Steatohepatitis is the more serious event, especially if accompanied by an increase in bilirubin levels. Modern understanding of the efficacy, safety and tolerability of combination chemotherapy has to increasingly include the individual context of a patient, such as age, gender, nutritional status, underlying diseases, genetic predisposition, as well as the cross-reactivity of the different drugs. This review tries to capture the various effects of chemotherapy on the liver, with a focus on chemotherapeutical compounds used for the treatment of gastrointestinal cancers.
Authors and Affiliations
Giuliano Ramadori, Silke Cameron
Keywords
Related Articles
- EP ID EP77925
- DOI -
- Views 112
- Downloads 0
Risk factors for acute kidney injury and 30-day mortality after liver transplantation
Introduction. The aim of this study is to evaluate the risk factors for acute kidney injury (AKI) and 30-day mortality after liver transplantation. Material and methods. This is a retrospective cohort of consecutive adul...
Hepatic insulin resistance ties cholesterol gallstone formation and the metabolic syndrome
Biddinger SB, Haas JT, Yu BB, Bezy O, Jing E, Zhang W, Unterman TG, Carey MC, Kahn CR. Hepatic insulin resistance directly promotes formation of cholesterol gallstones. Nature Medicine 2008; 14: 778–782.Despite the well-...
Nonalcoholic fatty liver disease in severely obese individuals: The influence of bariatric surgery
Background: Obesity is the most frequent risk factor associated with NAFLD, and bariatric surgery (BAS) is traditionally indicated for the treatment of severely obese individuals. Here, we discuss the behavior and progno...
Utility and safety of tolvaptan in cirrhotic patients with hyponatremia: A prospective cohort study
[sup][/sup] Introduction and aim. Hyponatremia is common in patients with decompensated cirrhosis and is associated with increased mortality. Tolvaptan, a vasopressor V2 receptor antagonist, can increase free water excre...
Drug induced liver injury: accuracy of diagnosis in published reports
The diagnosis of drug induced liver injury (DILI) is based primarily on the exclusion of alternative causes. To assess the frequency of alternative causes in initially suspected DILI cases, we searched the Medline databa...