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Liver Tansplant decision
A liver tranplant seems inevitable based on:
1) Dx: 4/2006 after near fatal vericeal bleed (secondary to HepC - which after treatment I have tested negative for over 4yrs now)
2) Three more near fatal variceal bleed episodes and countless ligation "banding"endoscopies.
3) The final variceal bleed was worst, and was followed up with a TIPS proceedure.
I have been in and out of encephalactic coma's, taking lasix, spironolactone, laculose, propanolol. But since the TIPS proceedure my B/P has been "normal" (without the propanolol). I've cut back on my use of lasix, spironolactone and lactulose. My Meld score has been running about 12-14. This all sounds great but remain convinced I will need a transplant but reluctant to trade one set of problems for another.
I'm under 50 yr married man with 2 children, 4 yr. college degree, in otherwise relatively good health. My short term memory is shot, along with concentration and attention span.
I'm at a loss for what to do and when to do it. Suggestions?
Thank You
1) Dx: 4/2006 after near fatal vericeal bleed (secondary to HepC - which after treatment I have tested negative for over 4yrs now)
2) Three more near fatal variceal bleed episodes and countless ligation "banding"endoscopies.
3) The final variceal bleed was worst, and was followed up with a TIPS proceedure.
I have been in and out of encephalactic coma's, taking lasix, spironolactone, laculose, propanolol. But since the TIPS proceedure my B/P has been "normal" (without the propanolol). I've cut back on my use of lasix, spironolactone and lactulose. My Meld score has been running about 12-14. This all sounds great but remain convinced I will need a transplant but reluctant to trade one set of problems for another.
I'm under 50 yr married man with 2 children, 4 yr. college degree, in otherwise relatively good health. My short term memory is shot, along with concentration and attention span.
I'm at a loss for what to do and when to do it. Suggestions?
Thank You
MEDICAL PROFESSIONAL
the best thing is that you have been cured of HCV which theoretically can allow your liver to have the cirrhosis regress with time. if further bleeding complications can be controlled with the TIPS i would wait things out. i realize that your quality of life is suboptimal with the encephalopathy but i think its in your best interest to wait. You must continue to have regular surveillance for hepatocelular carcinoma.
MEDICAL PROFESSIONAL
all of this is very appropriate
Dear Dr. Schiano,
Thank you for sharing your incite regarding my decision dilemma. I have another brief question (related to the first) which I hope you can also help with.
Is it at all customary and usual to go through all of the prerequisite testing, (CT scan, Ultrasound, EKG, Psychological, Dental, blood work, etc) to get appoved for listing. Then put ones self on an "innactive" status until such time that should my health worsen, I change my status to active.
Note: During this "inactive" time frame I would continue to follow the mandatory L/F blood tests, CT scans and Ultrasounds. If possible, could you provide me feedback on your feelings if someone approached you with this logic.
Thank you very much.
Thank you for sharing your incite regarding my decision dilemma. I have another brief question (related to the first) which I hope you can also help with.
Is it at all customary and usual to go through all of the prerequisite testing, (CT scan, Ultrasound, EKG, Psychological, Dental, blood work, etc) to get appoved for listing. Then put ones self on an "innactive" status until such time that should my health worsen, I change my status to active.
Note: During this "inactive" time frame I would continue to follow the mandatory L/F blood tests, CT scans and Ultrasounds. If possible, could you provide me feedback on your feelings if someone approached you with this logic.
Thank you very much.
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