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Hep c stage 3 or 4 liver disease
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Hep c stage 3 or 4 liver disease

Hi, I am new here but have been reading lots. I have just been referred to a transplant facility by my hep/GI doctor. The doctor said I am to far advanced to be treated for my hep virus. Just having a hard time understanding how I got here from what was supposed to be a simple gallbladder operation to cirrhosis and HCV virus in three months. I was hopeful for treatment at any stage of cirrhosis. Also have a fatty liver, diabetics,large spleen, portal hypertension with esophagus varies. My question is . Is my doctor correct that you can be to far advanced for treatment.

Thanks
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A slight correction...portal hypertension and esophageal varices are complications of stage 4 liver disease (not stage 3) More precisely 'complete cirrhosis' or cirrhosis with portal hypertension.

What I mean by complete cirrhosis is the liver disease is so advanced/scarred that the normal blood flow through the liver back to the heart is reduced (portal hypertension) it is forced by the portal hypertension to flow through collateral veins that don't normally carry so much blood. When this happens the blood pressure in these veins is increased and the veins become large and can sometimes burst from the pressure that they were not designed to carry. Some of these veins run along our digestive system. They are called varices.

Decompensated cirrhosis is when the liver is so damaged it can no longer perform all of its many functions. When the liver disease gets to this point other body systems get disrupted and the physical signs we coomnoly associated with cirrhosis can appear. The most common first sign of decompensation is ascites (fluid retention in the abdomen and low legs/feet). Other symptoms of decompensation are bursting varies. Varices commonly exist before decompensation as the portal hypertension increases but the portal hypertension pressure only becomes so high to cause bursting (usually resulting in the vomiting of blood) when the liver starts to fail (decompensation). Other signs of such as hepatic encephalopathy (HE) can exist when the liver is compensated and will only produce mild mental abnormalities. When then liver is decompensated HE can lead to stupor, coma and death. The difference between compensated liver disease and decompensated liver disease is the stages of the complications. It is only when cirrhosis becomes decompensated that some of these complication can become life-threatening.

So yes it is good that you are being referred to a transplant center. It is only after you have a full health evaluation at the center that you will know if you are able to treat your hepatitis C. The goal of the doctors at the transplant center is to keep you as healthy as possible for as long as possible. If curing your hep C and stopping the progression of your liver disease is an option that is what they will do. Liver transplantation is only the option of last resort when there are no other options available. Only few of us here on this forum have had to have liver transplants in order to remain alive. Most people are able to stop their liver disease before if has progressed to the point of liver failure or liver cancer for which the only solution is a life-saving liver transplant.

Hang in there. This is not an end, but the beginning of you getting the help you need to overcome this.

Hector
4 Comments Post a Comment
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Hi Nenan
Welcome to the forum!

Sorry to hear of your situation. I know how shocking it is to suddenly learn
you have Hep C and cirrhosis. The same thing happened to my husband.
Your situation sounds much like his was when he found out. You apparently have advanced liver disease. Some of the symptoms you listed (portal hypertension, esophageal varices) are signs of liver decompensation meaning your liver is having a very hard time functioning at this point. For this reason your doctor has referred you to a hepatologist at a transplant center.
Your doctor has done the right thing. You need to be evaluated for possible listing on a transplant list. The sooner you go through the process the better.
The doctors at the transplant facility will know what the best treatment for your Hep C is and when to best treat it (i.e. before or after transplant) if in fact you need a transplant.
    I do know how you feel and all I can say to you is to just take one day at a time and take good care of yourself.  Learn as much as you can about your medical condition.  Hopefully there is someone who can support you through the process as it can be overwhelming.
    Keep coming back here as there are lots of members here who will give you good advice and answers to your questions as you move ahead.  

I wish you the best as you move forward.

Nan
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446474_tn?1404424777
A slight correction...portal hypertension and esophageal varices are complications of stage 4 liver disease (not stage 3) More precisely 'complete cirrhosis' or cirrhosis with portal hypertension.

What I mean by complete cirrhosis is the liver disease is so advanced/scarred that the normal blood flow through the liver back to the heart is reduced (portal hypertension) it is forced by the portal hypertension to flow through collateral veins that don't normally carry so much blood. When this happens the blood pressure in these veins is increased and the veins become large and can sometimes burst from the pressure that they were not designed to carry. Some of these veins run along our digestive system. They are called varices.

Decompensated cirrhosis is when the liver is so damaged it can no longer perform all of its many functions. When the liver disease gets to this point other body systems get disrupted and the physical signs we coomnoly associated with cirrhosis can appear. The most common first sign of decompensation is ascites (fluid retention in the abdomen and low legs/feet). Other symptoms of decompensation are bursting varies. Varices commonly exist before decompensation as the portal hypertension increases but the portal hypertension pressure only becomes so high to cause bursting (usually resulting in the vomiting of blood) when the liver starts to fail (decompensation). Other signs of such as hepatic encephalopathy (HE) can exist when the liver is compensated and will only produce mild mental abnormalities. When then liver is decompensated HE can lead to stupor, coma and death. The difference between compensated liver disease and decompensated liver disease is the stages of the complications. It is only when cirrhosis becomes decompensated that some of these complication can become life-threatening.

So yes it is good that you are being referred to a transplant center. It is only after you have a full health evaluation at the center that you will know if you are able to treat your hepatitis C. The goal of the doctors at the transplant center is to keep you as healthy as possible for as long as possible. If curing your hep C and stopping the progression of your liver disease is an option that is what they will do. Liver transplantation is only the option of last resort when there are no other options available. Only few of us here on this forum have had to have liver transplants in order to remain alive. Most people are able to stop their liver disease before if has progressed to the point of liver failure or liver cancer for which the only solution is a life-saving liver transplant.

Hang in there. This is not an end, but the beginning of you getting the help you need to overcome this.

Hector
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Thank you very much for your help. I believe knowledge is power and you have gave me that. You guys/ladies are very valuable resources for us that do not completely understand the medical language /definitions .
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446474_tn?1404424777
Knowledge is power! It will help you to make informed decisions so you can chose what is right for you. Be involved with your own health care. Partner with your doctor and together you will overcome your hepatitis C and your cirrhosis. We all take different paths to accomplish this. Some roads are longer than others. Chose the best options for you and committed do doing them to the best of your ability and you will be successful.

There is a lot of lingo which in time you will get to know. If you see something you don't understand ask about it. You can also search the Internet and there are definitions of the medical terms. I learned many of the Hep C and liver disease from reading my own medical reports, tests and procedures I had. In time you'll be fluent too.

Best!
Hector
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