Cirrhosis of the Liver Community
Liver Bx, Fibroscan or Transjugular Bx
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Cirrhosis is the end result of chronic liver damage caused by chronic liver diseases. The purpose of the community is to share support and information with Cirrhosis of the Liver patients and their loved ones. Topics in the community include: causes, clinical trials, complications, family issues, living with Cirrhosis of the Liver, prognosis, research, surgery, treatments

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Liver Bx, Fibroscan or Transjugular Bx

I have heard that liver biopsy is the best way to go for staging cirrhosis but am wondering about the others...fibroscan and transjugular?    Are these just as accurate?  

Also, will these tests tell the cause of cirrhosis?.

P
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446474_tn?1399353933
'My US stated mildly hetergeneous echogencity liver non specific but may represent heptocellular (liver) disease'

The normal liver is soft, smooth, and has a hemogenous/consistent echo texture. When it states it is minimally heterogeneous...it means its surface has a different echotexture..( the ultrasound wave bounces off the liver surface so it can detect if the surface is not smooth ans shiny as it is when healthy) this could be that it is developing a more coarse appearance. If someone has Cirrhosis, due to dead liver cells the liver become nodular with a coarse echo texture.

'No masses, nodules, etc.'  
Good. No lesions like liver cancer found.

all other organs are fine and normal sized..no enlarged spleen
Strange because the spleen usually becomes enlarged before varices appear. Varices are a sign of portal hypertension due to scarring of the liver and reduced blood flow through the liver.

'My gastro told me it is cirrhosis because of my varices...'
I agree.

Don't worry about the cause. That is the doctor's job, not yours. That is why they get paid the big bucks! ;-)
You have cirrhosis. Please go to Cleveland Clinic they are one of the best in the world for caring for liver disease patients. You have early cirrhosis with a MELD of 7. Which is when you want to catch it. The MELD score starts a 6 and goes to 40 (near death). Now is the time to get all the help you can to avoid progression of your liver disease. Don't worry they will figure out the cause of your liver disease in no time. Once you know waht it is you will feel better and then take steps to manage it.
CC will also have clinical trials too.

If I could go anywhere else Cleveland Clinic would probably be my first choice. You are super lucky. Look at it this way. When you have a possible fatal illness you want the best care available, not second best or worse. Please get connected up with Cleveland Clinic. The sooner in the better. When your MELD gets to 15 or so they will list you. I have been working with my hepatologist for over 5 years now. We have been though some tough times and she has saved my life more than one. If and when you need help they will know you and you will be comfortable like I am at my transplant center. I know a tons of people there and it is nice to know they will look out for you.

I am hanging in. Doing the best I can. It is very scary now as we at the op of the waiting list are running out of time. The other 4 folks ahead of me are all in ICU and fighting to live one more day in hopes that there might be a liver that will save their lives. One died last weekend. I feel terrible about their situation. It is very upsetting. I wish I could help them somehow but I can't save myself either.
I am hoping they can hold on until we have some donor livers. I do not want to move up by having others die. I feel terribly guilty cause i probably have the best chance of surviving this. At the same time to have fought so hard and long for so many years and to die now is not something I want to happen either. I really want to live very badly...but this is mostly out of my hands. All I can do is try to stay positive and keep hoping somehow I will be saved in time. Whatever happens I will deal with it as best I can. I have come too far to give up now. As long as I am alive I will try to help others from ever ended up like me.

Take care Paula and please get help at Cleveland Clinic. You will be in good hands I promise.

¸.•´¸.•*¨) ¸.•*¨)
(¸.•´ (¸.•´ .•´ ¸¸.•¨¯`•

Hector
4 Comments Post a Comment
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446474_tn?1399353933
No. If you have cirrhosis then you already know your stage of liver disease. Cirrhosis. F4 on the Metavir scale. There is no reason to test if you already have been diagnosed properly as cirrhotic. Biopsy does not tell the difference between early and end-stage cirrhosis.

There are many tests to determine the cause of liver disease because there are many different causes of liver disease. Viral, hereditary, alcohol, drugs, autoimmune etc.

You need to been seen by a hepatologist (liver specialist) to determine the cause and extent of your liver disease.

The closest to you are

OHOU - Ohio State University Hospital, Columbus, OH
To schedule an appointment with one of our experts, call 614-293-6255.
or
University of Pittsburgh Medical Center, Pittsburgh, PA
Center for Liver Diseases
'The UPMC Center for Liver Diseases is a convenient point of access to the full range of liver disease care available at UPMC. Our hepatology specialists have a wealth of experience in managing every stage of liver disease. The UPMC Center for Liver Diseases offers referrals to a number of subspecialists, including experts in hepatobiliary and transplant surgery (via the Thomas E. Starzl Transplantation Institute of UPMC), therapeutic endoscopy, pathology, and oncology.

Hepatologists at the Center coordinate all aspects of patient testing and care and are responsible for communication with referring physicians, providing a seamless continuum of care. They also provide a 24-hour, seven-day-a-week hepatology consult service.

Whether for surgical evaluation, hepatobiliary disorders, chemotherapy for hepatic cancer, evaluation for transplantation, or admission to a clinical trial, the Center’s integrated approach to diagnosing and treating liver disorders provides patients with high quality care in a timely and convenient manner.'

People with liver disease can call the Center for Liver Diseases directly, at 1-800-447-1651.

Good luck!
Hector
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89592_tn?1391278022
Hi Hector...My US stated mildly hetergeneous echogencity liver non specific but may represent heptocellular disease,. No masses, nodules, etc.  all other organs are fine and normal sized..no enlarged spleen...but I do have gr 2 non bldg varices and portal hyper though no mention of PH on the US.  My gasto told me it is cirrhosis because of my varices...  That was my diagnosis..said I do not need a bx.  My Meld was 7 at last check.

I have a hep clinic here within 10 min

Cleveland Clinic is 45 mins away.  

I want to find out the cause and what I can do.  Could it be caused by alcoholic liver disease..have not had a drink in 7-8 yrs...autoimmne, hep, etc.  Can it be PBC?  

I will give a call to Cleveland Clinic and to the GHS Clinic here in Canton OH

Thank you...how are you doing?  

Thanks for being here for everyone.  You're appreciated more than you'll ever know.....  Paula

Blank
446474_tn?1399353933
'My US stated mildly hetergeneous echogencity liver non specific but may represent heptocellular (liver) disease'

The normal liver is soft, smooth, and has a hemogenous/consistent echo texture. When it states it is minimally heterogeneous...it means its surface has a different echotexture..( the ultrasound wave bounces off the liver surface so it can detect if the surface is not smooth ans shiny as it is when healthy) this could be that it is developing a more coarse appearance. If someone has Cirrhosis, due to dead liver cells the liver become nodular with a coarse echo texture.

'No masses, nodules, etc.'  
Good. No lesions like liver cancer found.

all other organs are fine and normal sized..no enlarged spleen
Strange because the spleen usually becomes enlarged before varices appear. Varices are a sign of portal hypertension due to scarring of the liver and reduced blood flow through the liver.

'My gastro told me it is cirrhosis because of my varices...'
I agree.

Don't worry about the cause. That is the doctor's job, not yours. That is why they get paid the big bucks! ;-)
You have cirrhosis. Please go to Cleveland Clinic they are one of the best in the world for caring for liver disease patients. You have early cirrhosis with a MELD of 7. Which is when you want to catch it. The MELD score starts a 6 and goes to 40 (near death). Now is the time to get all the help you can to avoid progression of your liver disease. Don't worry they will figure out the cause of your liver disease in no time. Once you know waht it is you will feel better and then take steps to manage it.
CC will also have clinical trials too.

If I could go anywhere else Cleveland Clinic would probably be my first choice. You are super lucky. Look at it this way. When you have a possible fatal illness you want the best care available, not second best or worse. Please get connected up with Cleveland Clinic. The sooner in the better. When your MELD gets to 15 or so they will list you. I have been working with my hepatologist for over 5 years now. We have been though some tough times and she has saved my life more than one. If and when you need help they will know you and you will be comfortable like I am at my transplant center. I know a tons of people there and it is nice to know they will look out for you.

I am hanging in. Doing the best I can. It is very scary now as we at the op of the waiting list are running out of time. The other 4 folks ahead of me are all in ICU and fighting to live one more day in hopes that there might be a liver that will save their lives. One died last weekend. I feel terrible about their situation. It is very upsetting. I wish I could help them somehow but I can't save myself either.
I am hoping they can hold on until we have some donor livers. I do not want to move up by having others die. I feel terribly guilty cause i probably have the best chance of surviving this. At the same time to have fought so hard and long for so many years and to die now is not something I want to happen either. I really want to live very badly...but this is mostly out of my hands. All I can do is try to stay positive and keep hoping somehow I will be saved in time. Whatever happens I will deal with it as best I can. I have come too far to give up now. As long as I am alive I will try to help others from ever ended up like me.

Take care Paula and please get help at Cleveland Clinic. You will be in good hands I promise.

¸.•´¸.•*¨) ¸.•*¨)
(¸.•´ (¸.•´ .•´ ¸¸.•¨¯`•

Hector
Blank
89592_tn?1391278022
Just wanted to let you know that I made an appt on Monday to see Dr Barnes at the Clevelanf Clinic though I cant get in till March 28th..wish it was sooner.  Hate waiting.  

I wanted to talk to my old gastro to find out why he never called me about my US and he said well, we dont call if you have a stable US?  Stable compared to what..this was my first US..  He looked thru my results and said..oh you just have fatty liver.....thats why we didnt call you. Everything is normal  I said oh, a fatty liver WITH VARICES???  He said..oh you had varices?  Yes.  Then you do have cirrrhosis. (Reason for the new gastro...)  He wanted to schedule me for some testing and I said no thanks....I have another gastro now and then will be going to CCF.

I cant imagine how you're feeling about the transplant and waiting while there are other patients in the ICU fighting to get a liver.  It must be so tough but what can you do? Fight for yourself, whcih you are doing with aplomb.  You have to get that transplant...we want it for you too!!  We want no less.  Lots of prayers are being said for you....

We're family..  Hugs..Paula
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