heart transplant § liver disease

[jwb34]

My father has had 2 valve repairs (1998 & 2001) & was dx with CHF 2 years ago (& his valve is also leaking again).  He was placed on a transplant list in 12/03, but was recently taken off due to liver disease (he had his gall bladder removed 7/04 & began retaining water, resulting in their doing a liver biopsy).  It has been described as not yet chirrosis, and of a kind that will likely get better over time.  His current heart team is relatively new to doing transplants & are concerned that the risk of tranplant outweighs the benefit.  We are upset because we feel transplant is his last hope & he is young (65).    Do you perform heart transplants on patients with liver disease?  Outside of transplant, are there any other options/treatments available to him (meds did not work in the past, which is why he was put on the transplant list).  I should note that he isn't hospitalized at this time, nor is he on milrinone.

[CCF-M.D.-MJM]

Hello,

This is a very good question.  First, one key factor in the success of heart transplant is an experienced transplant team.  Yes, we do transplant and are one of the highest volume centers in the world.  Our success rate and survival is statistically very good compared.

Whether we transplant with liver disease depends on the type of liver disease.  Severe heart failure causes fluid retention and congestion of the liver mimicing cirrhosis.  Optimizing the heart failure will help the liver if this is the cause.   If he does not respond to medical therapy, we sometimes us an invasive heart pump called a left ventricular assist device (LVAD) to bridge to transplant.  Other centers will sometimes use medications like milrinone, dobutamine, and dopamine to treat the heart failure and sometimes bridge to transplant.

Consider getting a secnd opinion at another transplant center.  If you decide to do this, make sure you collect all your records from the other hospital including echo tapes (in addition to reports), left heart catheterization films (the tape and the report), labs and clinc notes.

If you live near Cleveland (or even if you don't), we would love to help.

Good luck and I hope this helps.

[pms_barbie]

Hello im very sorry to hear of your fathers situation.  Several fatctors from what I understand and this is just wht I have gathered which could be completely off bade.  Your fathers live condition could be very damaging to a transplanted heart.  The liver handles most of the drugs that we take.  I dont know exactly what all kinds of meds you have to take after a transplant except for sandimun.  However if they liver can properly distibute or eliminate these drugs it can becaome toxic for the transplanted heart.  Causing it to die or reject. HAs anything been said about a liver transplant?  If they expect his liver to get better then maybe they will re add him at that point int time..

[jwb34]

I don't think his liver condition is serious enough to require a transplant.  Right now, his only treatment for it is to avoid all salt.  His heart doctor also discontinued amniodorone, which I've been told is damaging to the liver.  The concern raised by his heart team was whether hecould survive the surgery, as opposed to whether he can tolerate meds (unfortunately, he has had to take tons of meds for quite a while now).  His doctor feels of my father's chance of survival for the next year is higher than his chance of survival if he underwent a transplant surgery right now.

[pms_barbie]

Im really sorry you all are going through this.  I have heard amnio can be very damaging to the liver.  Maybe the withdrawl of that med will help alot.  I know it has a half life of like 6 months.  I wish your father the best of luck and maybe the dr can give you a lot better insight and ideas.

[jwb34]

Thanks for the information.  From your response, it seems that unless the liver disease is caused by the CHF (& I don't think it is), a transplant is unlikely.  Is that right?

[Erik36]

I love you all. Please, no more animosity! We're all decent human beings whether new or old on this forum. People are arguing over stupid things. Medhelp might pull the plug on all of us. Let's just go back to our normal routine. Welcome, new and old posters. We'll all do what we do and coexist with each other in peace. Everyone have a good night.


Erik

[hankstar]

oops I forgot!!

[pms_barbie]

You are so right and I am sorry I didnt just forget it sooner.  I wish every one here happy heart days.

[jollynick]

Wow I've been an observer here for a while and want to know if you EVER get over your PMS?  You have to be one of the most negative persons I've seen in medical forums.

tis the season to be "jolly"....So.....

"Jolly the F*** up"

jollynick

[pms_barbie]

Yeah right you have been here a long time.  If you have you would know we dont use your little f word here.....lmao to funny.

[donray]

Im sorry to hear about your unfortunate circumstance but i know of a product that may be able to help you its worth a try  listen to the testamonial of this gentleman who was on a trnsplant list as well

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It can be found at www.newheartand body.com Good Luck!