Join Eoin Tabb on the Irish Haematology Oncology Podcast for a deep dive into hepatic impairment in cancer patients. We'll break down the vital functions of your liver, how we measure its health, and why this is crucial when planning chemotherapy. Whether you're a new healthcare professional or a seasoned expert, this episode is packed with insights on how to navigate the complexities of chemo dosing when the liver isn't functioning at its best. Tune in to learn how to keep your patients safe and optimize their treatment outcomes!
Podcast Show Notes:
The Liver: Your Body's Metabolic Powerhouse and Detoxification Center
The liver's multiple roles: detoxification, nutrient processing, production of essential substances
The liver's role in medication metabolism
The impact of hepatic impairment on chemotherapy: increased drug levels, decreased drug activation, altered blood flow, and protein binding issues
When the Liver Hits a Snag: Types and Causes of Hepatic Impairment
Degrees of hepatic impairment: mild, moderate, severe
Common causes: chronic liver diseases (cirrhosis, hepatitis, NAFLD), medications (chemotherapy, other drugs), alcohol abuse, other causes
Types of liver damage: hepatocellular, cholestatic, mixed
Measuring Liver Health: The Tools and the Challenges
Child-Pugh score: assessing liver function based on bilirubin, albumin, INR, ascites, and encephalopathy
NCI Organ Dysfunction Criteria: focusing on bilirubin and liver enzymes (ALT, AST)
The importance of context and clinical judgment in interpreting test results
The Domino Effect of Hepatic Impairment on Chemo:
Increased risk of toxicity
Issues with prodrugs
Impact on biliary excretion, blood flow, and protein binding
The importance of individualizing treatment based on cancer type, treatment goals, and patient resilience
The challenges of dose adjustments
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