NASH RELATED CIRRHOSIS

Dr, Though I e-mailed you before  regarding my concerns with having hip replacement surgery, my job, insurance etc.,  it's unlikely you will remember me so II will briefly tell you my situation.  My alt/ast were in the 300's and climbing.  After many tests a biopsy was performed and  my liver was found to be cirrhotic at stage 4 and I was told that it is considered irreversible. Though I never had any symptoms other than fatigue.  
Now I'm told I have a mass near my right kidney and advanced Barretts.
My spine is at high fracture risk so I have a few things that make me vulnerable.

My question is since my cirrhosis is due to NASH (though I am not obese) will I be consdered for a transplant when the need comes? In other words, will there be concern that the NASH will attack the donor liver and therefore I might not be considered a successful candidate?  Since I don't drink, really have no weight to lose, etc.

One more question please....  The "suspious " mass (that is what the report said) near my kidney.  Why would they not want to go in and do a biopsy?
Is such a mass considered fairly common with folks who have cirrhosis?  

Thank you for your help

[Thomas D Schiano, MD]

NASH-related cirrhosis is not a contraindication for transplantation, and in fact its probably the most increasing common cause for liver failure. Although fatty liver can recur post-transplantation, few patients run into problems with graft failure.  If the renal lesion is indeed unequiovally a neoplasm they would want to take it out.  Its probably small enough to follow expectantly to see if it grows which obviates the need for the biopsy which can have a potential false (-) miss rate.

[girl4tide]

Dr Schiano
Oh what a relief regarding the NASH!  I am so fretful because I cannot understand why I have it in the first place.  No alcohol, no drugs, not obese... etc., etc.,   I was afraid the review board would deny me as too high a risks.  I will try to be diligent in doing all that I can do to remain compensated for as long as possible.  It is becoming increasingly apparent that I will have to undergo the hip replacement and I hope that does not cause issues with the liver.
To be quite frank with  you, I am determined to reverse the irreversible.  I intend on turning my liver back around.  Then you  will have my persmission to write the first case study report about my success.

Regarding the mass, I found the results and want you to know I was erroneous in saying the report stated "suspicious", it was probably my mind thinking it was suspect.  Here is what it literally stated :   "There is a very questionable 3.5x 2.7 x 1.8 cm low density mass near the margin of the right kidney."

Dr. Schiano, I cannot comprehend a man of your responsibilites taking time to help folks like me. We are just so scared and overwhelmed I think.   I take lists of questions when I see my Dr. but, somehow, I find more questions or I can't seem to clearly understand or, more correctly absorb what is being said.   I come home and days later my mind reels with questions.
Just wanted to say thank you, thank you, thank you.

[Thomas D Schiano, MD]

very often there may be small renal abnormalities found on screening CT scans that are not cancer at all.  These should be followed over time. the power of positive thinking is also helpful--keep it up.  good luck.

[girl4tide]

Be rest assured I I shall make CERTAIN that little puppy is monitored.
My thoughts are I have 2 ways to go.... Hope  and no hope.
I prefer hope.

Again, thanks for your time and comments.

Barb'