66 INCORPORATING ADVANCE CARE PLANNING IN ADULTS WITH DECOMPENSATED CIRRHOSIS AT LIVER TRANSPLANT CENTERS: A NURSING-LED EDUCATIONAL INITIATIVE Janet Gripshover 1,2 , Rita DAoust 1 , Deborah Baker 1 and Arpan Arun Patel 3 , (1)Johns Hopkins University, (2)University of California Los Angeles, (3)Greater Los Angeles VA Healthcare System Background: Clinician inexperience with advanced care planning (ACP) is a barrier to patient-centered care for adults with decompensated cirrhosis (DC) at liver transplant centers
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Crucially, this study shifted the scientific paradigm from a simple model of "glutathione depletion" to a model of an "overwhelmed compensatory mechanism." The discovery that circulating immune cells in these patients actually have elevated glutathione levelswhile simultaneously suffering from a severe depletion of other protective enzymes like SOD2revealed that the cells are desperately, and unsuccessfully, trying to fight off a catastrophic level of oxidative damage
Zhu M, Hua T, Ouyang T, Qian H, Yu B
