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What is the criteria for a liver transplant?
Hello! I am new to this community. I am not the one with cirrhosis - my sister is the one with this condition. She drank every day from the time she was 14 yrs. old until she was admitted to the hospital 5 yrs. ago at death's door at the age of 54. We don't live close to each other, and we haven't seen too much of her over all these years, but we speak on the phone at least once a month. Anyway, when she was admitted to the hospital, her friend said she was so full of ascites that she looked like she was 12 months pregnant with triplets. Her friend had to force her to go to the ER that day because my sister was in so much denial, she didn't see the problem. While in the hospital, she had to be transfused many times because her platelet levels were so low. She was vomiting blood for many months before that and was bleeding from the "bottom end" too. She was diagnosed with ESLD at that time according to her friend. My sister never admitted to any of this. We found out through her friend. We were forbidden to go and see her and I guess she took care of herself when she was released from the hospital. I know it has not been easy for her. She was a walking skeleton for over a year after her hospitalization. She had a weird color and her eyes were yellow for over a year too. I don't know how she looks now.
Fast forward 5 yrs. and we still don't know too much about her health. We don't know if she relapsed and went back to drinking here and there or not during this time. (But we have suspected it.) She was only on a low sodium, no-alcohol diet up until about 6 months ago when her doctor put her on a diuretic and an even more restricted salt diet. (maybe other meds too, but she only spoke of the diuretic.) She has had some kidney problems - but I don't really know the details. She has been up and down with mood swings and has had problems keeping a job for any length of time. I suspect that she's had some HE problems at times, but she may be on medication for this now because she seems to be more level in her moods. I can only guess. I have been caring for other family members for the past 5 yrs, and I now care for my elderly mother. It is difficult for me to go see her, but I don't think she wants me to see her. So we talk occasionally on the phone. She never comes up to see us and this is so sad for my mother.
My question is this: What is the criteria for her if she will need a liver transplant? She never went to AA after her hospitalization 5 yrs. ago. She felt she could do it on her own after drinking for over 40 yrs. I have no idea what her MELD score would be, and I have no idea what her health is like. But I have the little "clues" here and there that she may be progressing to a new stage.
Fast forward 5 yrs. and we still don't know too much about her health. We don't know if she relapsed and went back to drinking here and there or not during this time. (But we have suspected it.) She was only on a low sodium, no-alcohol diet up until about 6 months ago when her doctor put her on a diuretic and an even more restricted salt diet. (maybe other meds too, but she only spoke of the diuretic.) She has had some kidney problems - but I don't really know the details. She has been up and down with mood swings and has had problems keeping a job for any length of time. I suspect that she's had some HE problems at times, but she may be on medication for this now because she seems to be more level in her moods. I can only guess. I have been caring for other family members for the past 5 yrs, and I now care for my elderly mother. It is difficult for me to go see her, but I don't think she wants me to see her. So we talk occasionally on the phone. She never comes up to see us and this is so sad for my mother.
My question is this: What is the criteria for her if she will need a liver transplant? She never went to AA after her hospitalization 5 yrs. ago. She felt she could do it on her own after drinking for over 40 yrs. I have no idea what her MELD score would be, and I have no idea what her health is like. But I have the little "clues" here and there that she may be progressing to a new stage.
COMMUNITY LEADER
I am sorry to hear about your sister’s liver disease and her life-long struggle with alcoholism.
At a basic level patients are considered eligible for liver transplantation if the following conditions are met:
* The development of End-Stage Liver Disease (ESLD)
* The absence of systemic illness or other medical conditions relevant to future survival
* Full comprehension of transplant procedures and responsibilities
Contraindications for Liver Transplant
Patients are not considered transplant candidates if any of the following conditions exist:
* Active drug or alcohol use
* Patient history indicating other end-stage medical conditions
Donor livers are scarce, donated organs are precious, and transplant centers must make the final call on whether to transplant a particular patient. Every day people waiting for organs in the US die because there are not enough organs available for everyone who needs one. At my transplant center we have over 700 people who are waiting for a liver right now.
The bottom line is it is up to your sister to be responsible for her lifestyle and its resulting health issues. Only she can help herself. No one can do it for her.
Since it appears that her liver disease has been caused by the abuse of alcohol, it is up to her as an adult to choose whether she continues to drink and cause further damage to her liver or stop drinking and recover her health and liver assuming it isn’t already too late and her liver disease is irreversible.
Please understand that a person who continues to drink will not be eligible to receive a liver transplant. People who have a history of alcoholism or other substance abuse issues have to prove to have changed their lifestyle in order to be listed to be eligible to receive a donor liver.
Transplant centers commonly require patients to prove that they have stopped drinking for a minimum of six months before being listed for a transplant as a way of assuring doctors they are serious about staying sober after the operation. Patients also will be tested while waiting for an organ and if they are found to be noncompliant they will be removed from the waiting list.
Getting and living with a liver transplant requires a person to go through often a long waiting process while getting sicker and more disabled until they get to the top of the waiting list and will receive an organ. Meaning they have to be the sickest patient with their blood type to get the next organ. Depending on where a person is listed for transplant, this can require a MELD score of about 20 something to 35 or higher. Some of us waited many years for a transplant after first being diagnosed with cirrhosis to receive our new livers.
After the surgery there is a long recovery period which can take months to years. To maintain their new health and new organ, a transplant recipient must take daily medicines for the rest of their life along with having monthly labs and other tests to watch for any signs of problems with their new liver. For those who are not able to manage these responsibilities outcomes are poor. Which is why organs are only given to those who are expected to do well after transplant.
I wish you and your sister the best.
Hector
At a basic level patients are considered eligible for liver transplantation if the following conditions are met:
* The development of End-Stage Liver Disease (ESLD)
* The absence of systemic illness or other medical conditions relevant to future survival
* Full comprehension of transplant procedures and responsibilities
Contraindications for Liver Transplant
Patients are not considered transplant candidates if any of the following conditions exist:
* Active drug or alcohol use
* Patient history indicating other end-stage medical conditions
Donor livers are scarce, donated organs are precious, and transplant centers must make the final call on whether to transplant a particular patient. Every day people waiting for organs in the US die because there are not enough organs available for everyone who needs one. At my transplant center we have over 700 people who are waiting for a liver right now.
The bottom line is it is up to your sister to be responsible for her lifestyle and its resulting health issues. Only she can help herself. No one can do it for her.
Since it appears that her liver disease has been caused by the abuse of alcohol, it is up to her as an adult to choose whether she continues to drink and cause further damage to her liver or stop drinking and recover her health and liver assuming it isn’t already too late and her liver disease is irreversible.
Please understand that a person who continues to drink will not be eligible to receive a liver transplant. People who have a history of alcoholism or other substance abuse issues have to prove to have changed their lifestyle in order to be listed to be eligible to receive a donor liver.
Transplant centers commonly require patients to prove that they have stopped drinking for a minimum of six months before being listed for a transplant as a way of assuring doctors they are serious about staying sober after the operation. Patients also will be tested while waiting for an organ and if they are found to be noncompliant they will be removed from the waiting list.
Getting and living with a liver transplant requires a person to go through often a long waiting process while getting sicker and more disabled until they get to the top of the waiting list and will receive an organ. Meaning they have to be the sickest patient with their blood type to get the next organ. Depending on where a person is listed for transplant, this can require a MELD score of about 20 something to 35 or higher. Some of us waited many years for a transplant after first being diagnosed with cirrhosis to receive our new livers.
After the surgery there is a long recovery period which can take months to years. To maintain their new health and new organ, a transplant recipient must take daily medicines for the rest of their life along with having monthly labs and other tests to watch for any signs of problems with their new liver. For those who are not able to manage these responsibilities outcomes are poor. Which is why organs are only given to those who are expected to do well after transplant.
I wish you and your sister the best.
Hector
You have to be evaluated by a transplant team and get on a waiting list. Check mayo clinic on line and they explain the process. She would have to go to a major hospital that does the procedure it depends where you live
2 Comments
With what little history I could give you, do you think she could have gotten off scott-free from any lasting effects? For some reason, I am afraid for her now. I'm not sure why. Just vibes I guess but I'm more concerned for her than I am my elderly mother. I can't ask her - she has never been truthful or forthright about herself. I don't want to address this with her if I am just worried about nothing.
It is hard to say without talking to her Dr.s you could ask her what medications she is on and express your concern. If she is not telling you the truth there is nothing you can do to help her. It doesn't help to worry because that does not make the problem go away. Good luck.
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