Meld score wait time

Hi.
My boyfriend's MELD score just shot up to 28. His kidneys are  now not functioning well either,  and his creatinin's numbers are off. His was discharged from Mt. Sinai last Tuesday, but yesterday he was re-admitted to Staten Island U. Hosptial with difficulties breathing and lots of distension due to fluids. They removed about 4 liters yesterday and he will be tapped again on Monday.

My question is: How long can a person with his conditions and a MELD score of 28  continue to live? (provided a liver will not become available?)

He was told he was number 2 on the list, though I didn't think there was such a '
numbering' system.

I am all the way in in California and he is in NY...I am just trying to get an idea about time and how imminient a crisis would be.  I am a techer out here and a single parent and I am trying to work out scheduling and logistical time issues.


Thank you so much
Lucia

[Thomas D Schiano, MD]

sorry to hear this.  he needs to be transplanted ASAP.  the 3 month survival with a MELD score like this is about 50%.  Do his doctors know that he is in the hospital? Do we need to transfer him to Mt Sinai?

[marilu59]

Thank you for your reply Dr. Schiano;
I had not connected that you were at Mt. Sinai..

My boyfriend happens to be on the list at Mt. Sinai, in addition to being listed with  Thomas Jerfferson U> in Phyladelphia.  Rene' is his name, and he tells me he has seen you there, and that you are an expert in your field.

His hepatologist at Mt. Sinai is Dr. Liu...Though he was told that he was number 2 in NY, he was released from Mt. Sinai on the 2nd of March...We couldn't understand why.

His MELD has gone to 26 by now.

I am appealing to you to see if there is something further we can do.  Should he be re-admitted?? He is in terrible discomfort and retainining quite a bit. He was told today that his breathing difficulties are due to the pressure pushing up on his lungs...

He is a good trasnplant candidate. He does not use any alcohol or drugs, is in good shape and eats very well. He is only 49 years old.

He was considering living donation up until he was told his meld was too high...

I thank you for any input,
Respectfully,
Lucia

[Thomas D Schiano, MD]

Lucia, i think if he is out of the hospiuyal he may need to come to the ER at Sinai.  i am concerned.  Please also get in contact with dr liu ASAP.

[marilu59]

Thanks again Dr. Schiano,

Rene was seen by Dr. Liu yesterday, 3/9/10 for an MRI.

He has another appt  with him on the 23rd of March.

I can't help but feel that he may have been discharged prematurely on Tuesday March 2nd from Mt. Sinai  since he was  back to the ER in SI on the Friday of the same week, the 5th of March. He only spent 4 days at Mt. Sinai. ( and that was mostly during the weekend)

I don't want to overextend myself or seem inappropriate, but could he make an appointment with you?  I don't doubt that Dr. Liu is a fine Doctor, but is this  possible?

We are very worried and it's been heartwrenching.

I thank you so much for your time, you have been super helpful.

Lucia  Fatone

[Thomas D Schiano, MD]

lucia, right now we shouldn't change things mid-stream.  Dr Liu knows rene very well. rene is close to getting transplanted--I think very close.  for any concerns just bring him to sinai ER.  feel free to contact me at any time to discuss.

[marilu59]

Thanks for your advice Dr. Schiano..
I appreiciate your feedback and help..
I will keep you posted if that's ok..
Have a blessed day,
Lucia Fatone

[marilu59]

Hi Dr. Schiano,

Rene's has been having violent and persistent cough attacks pretty much since he got 'sicker'.

He was due to have his endoscopy (varices bound?)  around the time he was admitted at Mt. Sinai ( the beg of Feb.)- but then hee was told he would not need to to have it done...

He's been worried that this awful cough that he's had (apparently caused by the pressure from the distension on his lungs) might disrupt his bands in his esophagus...and  that he might bleed?

He was finally re-scheduled to have his endoscopy done this Friday....
Should there be any concern about his cough and the bands??

Thanks so much Dr. Schiano,

Lucia

.

[Thomas D Schiano, MD]

the cough is more likely related to the ascites.  don't worry about the cough making the varices bleed.