What to expect

[MJWEST68]

My father was diagnosed with cirrhosis two years ago and we were told he needed a transplant but he was too old and ill to have one. He was given diuretics to relieve the build up of fluid in his abdomen. This seemed to be working up until a month ago. He now has fluid in his abdomen, lungs and legs. His GP told him to increase the dosage of diuretics but he is struggling to breath. He has become jaundiced again and he has now started to vomit and is being taken into hospital. He is due to have tests, scans etc..but after being told two years ago that his life expectancy wasn't good...is this the beginning of the end...so to speak. What can I expect?

[MJWEST68]

Thank you so much. He was taken into hospital last week and had some tests done and was due to see a gastroenterologist on Saturday but decided not to wait and discharged himself. He is going to see the gastroenterologist this week so hopefully we will know more.

[fntn]

Sorry to hear that your father isn't doing well. ESLD is a tough road for both patient and family. And just a GP doctor isn't enough to deal with the complications that come with it. Is it possible for you to get a hepatologist assigned to him? Or, at the very least, a good gastroenterologist? And, is a transplant possible if his health gets better?

Ascites will need to be controlled, one way or another, to maintain a quality of life. Hopefully the increases to his diuretics will be enough to get things back under control. His doctors will need to watch his kidney function very closely since the diuretics, along with the strain of the portal hypertension, will be pushing them very hard. Once the ascites is back under control, his edema should reduce in severity. If the diuretics don't work, then needle fluid extraction (parenthesis) can be done.

With the recent increase in bilirubin (jaundice) and nausea, he may have some type of blockage that can be treated. And hopefully the scans will show what's causing trouble, if it is an external blockage. But, it may simply be his loss of liver function though that is causing this.

If you'd like, you could post some of his serum numbers and we maybe able to help you further assess his current status. With some of the numbers, his MELD (Model for End-stage Liver Disease) score can be calculated and this is what his doctors use to gauge where his liver function stands. Numbers for MELD: INR, creatinine, bilirubin.

But, in general, it's very hard to tell where a given patient stands wrt their future due to ESLD. Even his doctors won't be able to give you an accurate number until the end gets very close. If his kidneys can hold out, then he may last for some time.

Take care and we're here if you have questions.