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My brother's ill
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My brother's ill

Hi,

My brother, aged 36, is suffering from liver cirhosis due to alcohol. He is awaiting liver transplant from his wife. But the transplant is on standby due to:
-His Hamoeglobin is down to 6.5
-His creatinine is 1.4
-His PR and INR are also high.

The doctors have stopped all meds and have asked to wait till kidney heals up. But we are loosing patience. Need your expert advise. Please help.

Regards,

-Amber
Avatar_dr_f_tn
Hi!
You are  very apprehensive I know. Liver transplant surgery is a major surgery. The patient undergoing surgery should be haemodynamically stable before the surgery. Your brother’s hemoglobin is very less it should be corrected before surgery as there can be increased bleeding during surgery. He may need blood transfusion. INR tests are usually done prior to any surgery to look for any bleeding problems.INR may be high in  liver diseases and may need to be corrected by giving vitamin K.Your brother seems to be in early stages of hepatorenal syndrome since his creatinine is little high. It is raised in end stage liver disease due to vasoconstriction of large and small renal arteries and impaired renal perfusion .He may need expansion of intravascular volume with albumin and fresh frozen plasma. I will advise you to follow your doctor’s advice and keep patience. The doctor knows what is best for your brother and when is the appropriate time for transplantation based on his blood parameters. Have a frank discussion with his doctor and share all your concerns. Do write to us again.
Take care and best luck!
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