1084115 tn?1385228589

How is your blood labs

Hello everyone,

I hope its not to personal to ask.
I would like to know how's your blood work looks like and if you considered compensatet or decompensatet.are you on a tp list?
I mean what is your platelets,how's your bilirubin,how is your inr,how is your albumin,creatinin?

Thanks for some answers
Best Answer
446474 tn?1446347682
Hi Marc.

"does a child score 5 mean one is compensated? "
A 5 is class A compensated cirrhosis. But it can not tell the difference between someone with minimal cirrhosis and someone with no liver disease at all. That is why it should be only used for persons who have been diagnosed with cirrhosis by liver biopsy or some other means.

The Child-Pugh score is a scoring system to measure the severity of cirrhosis.

It is composed several point categories which include

total bilirubin, μmol/l (mg/dl)
50 : 3 points

serum albumin, g/l
> 35 : 1 point
28 - 35  : 2 points
< 28 : 3 points

  2.3 : 3 points

presence of ascites  
none : 1 point
mild : 2 points
moderate to severe : 3 points

presence of hepatic encephalopathy  
none : 1 point
grades I - II (or suppressed with medication) : 2 point
grades III-IV (or refractory) : 3 point

The point scores are then added up and classed as three categories such as
class A : 5 - 6 points
class B : 7 - 9 points
class C : 10 - 15 points

Class A is compensated cirrhosis.
NOTE: Anyone with a normally functioning liver (including someone with no liver disease) will have a Child-Pugh score of 5.

The Child-Pugh scale is only applicable in persons with complete cirrhosis.

* Incomplete cirrhosis is the presence of bands of fibrous tissue from portal areas to adjacent (Terminal Hepatic Veins) THV (and from THV to THV) but without the presence of encircling fibrosis. Often called stage 3/4.
* Complete cirrhosis is defined as the presence of fibrous bands completely encircling groups of hepatocytes. This creates portal hypertension. Stage 4.

Child’s classification/score has been largely replaced for liver transplantation by MELD scoring. Since the MELD scale range is from 6-40 (the higher the number the more likely the chance of death in the near future) You or a person who has no liver disease Stage 0 or stages 1-3 would both have a MELD score of 6. Again the MELD score is not helpful because having normal blood values indicates no liver dysfunction.

Looking at your lab results...

Your bilirubin is within norms.
Your Albumin is within norms.
INR is within norms.
Creatinine is within norms.
Platelet count is within norms.

All of your blood levels are within normal range.

Assuming a biopsy diagnosed you as having cirrhosis (?) you must have very minimal cirrhosis without any or very little portal hypertension. Called "incomplete cirrhosis". The Ultrasound would have seen if you had portal hypertension. Signs of portal hypertension including splenomegaly. People with portal hypertension usually will have a low platelet count also due to the enlarged spleen sequestering platelets, causing the platelet count to be lower. With complete cirrhosis an endoscopy will also show varices due to the increased portal blood pressure which forces the blood flow around the scarred liver. This is why it is common for cirrhotics to have platelet counts below 100,000. I had a platelet count below 70,000 from 2007 until my transplant 6 weeks ago.

According to your blood levels you have a fully functioning liver and can still treat your hepatitis C (if you haven't already) and stop further damage to your liver. Your liver can recover from the damage already done.

This is all good news.

Be well.
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1084115 tn?1385228589
I forgot to ask about if HE ,varices or Ascites is present.
my actual meld is 6 cpt is 5 but I guess these numbers don't correlate with how one is feeling.
hector told me once that some people with a meld of 15 feel fine while others with a meld of 8 suffering tremendous
Helpful - 0
Avatar universal
Hi Marc,
I posted all of my husband's recent labs in my journal a couple of days ago, and you are welcome to look at it.  He was diagnosed with Cirrhosis in 2010, is MELD 6, considered well-compensated, and does not have ascites, varices, or HE.
Helpful - 0
446474 tn?1446347682
Compensated or decompensated cirrhosis is not determined only by blood tests. Certainly no one blood value tells the whole story and peoples normal blood values varies between individuals.

Decompensation usually is determined by the various obvious symptoms of the complications of cirrhosis. Ascites, etc. The complications from decompensated cirrhosis can be life-threatening but can usually be controlled in the early stage of decompensation with treatments.

The Child-Pugh score which characterizes the stages of cirrhosis contains BOTH lab ranges and cirrhosis complications which occur when the liver can no longer maintain all of its functions.

Blood work alone will determine a person's MELD score and need for a transplant (which varies from a minimum of 6 to a high of 40. Only a MELD score > 15 indicates that a person will have a greater chance of living longer with a transplant ) but at what number a person becomes decompensated varies among patients.

Ascites and edema are commonly the first indication of decompensated cirrhosis.
Signs of decompensated cirrhosis also include bleeding varices, hepatic encephalopathy (Minimal HE can be present in compensated cirrhosis), jaundice, pruritis, itching, easy bruising and prolonged bleeding, gynecomastia (enlarged breasts in men), loss of libido, loss of body hair, more prone to serious infections, weight loss, and many more.

Helpful - 0
1084115 tn?1385228589
Thank-you You for posting.so does a child score 5 mean
one is compensated?
My latest lab results are
Bilirubin 16 ummol
Albumin 45
Inr 1.0
Creatinin 80 ummol
Platelets 213
us was normal

Helpful - 0
446474 tn?1446347682
Here are my blood levels from October 2013 about a month before my transplant for HCC. Patients who are transplanted for HCC not liver failure obviously have better liver function. My 36 MELD score points were based on the time (29 months) it took me to get to the top of the waiting list. I had been diagnosed with cirrhosis in 2007.

Bilirubin, Total 0.2 - 1.3 mg/dL                   2.3 H

Creatinine 0.71 - 1.22 mg/dL                      0.74

Albumin, Serum / Plasma 3.5 - 4.8 g/dL     3.2 L

Int'l Norm Ratio 0.9 - 1.2                             1.0

Platelet Count 140 - 450 x10E9/L             70.0 L

Aspartate transaminase 17 - 42 U/L         98.0 H

Alanine transaminase 12 - 60 U/L             64.0 H

If I was to include all of my lab results you would see that as time went on and my liver disease got worse I had more and more High or Low lab values.

Helpful - 0
Avatar universal
Unfortunately,  this is my husband's most recent labwork -  1 year and a half years post-transplant.  Recent liver biopsy shows cirrhosis.

Bilirubin, Total 0.2 - 1.3 mg/dL                    2.1 H
Creatinine 0.71 - 1.22 mg/dL                      1.8 H
Albumin, Serum / Plasma 3.5 - 4.8 g/dL     2.0 L
Int'l Norm Ratio 0.9 - 1.2                             1.4 H
Platelet Count 140 - 450 x10E9/L            123.0 L
Aspartate transaminase 17 - 42 U/L         83.0 H
Alanine transaminase 12 - 60 U/L             31.0
Helpful - 0
1084115 tn?1385228589
thanks alot for your answers.

i just dont get it why iam feeling so sick.(alltough iam afraid its unfortunetly my liver starting to get worse)
i have to ad that my labs in summer were more bad. inr was 1.1,bilirubin was 28.
now they improved.
my gastro and hepatologist(both working hand in hand at the transplant center)now ordered a mri of my abdomen and a gastroscopy to become an idea why i feel so sick(feel cold ,bloated,very anxious and scared pain everywhere and nauseated all the time.


Helpful - 0
Avatar universal
You have treated and cleared your Hep C virus, so there is nothing further damaging your liver.  Your labs are all in the normal range.  You have regular imaging which have shown no sign of any problems.  You don't have ascites, HE, or varices.  You mentioned in another thread that you've been to two different hepatologists in two transplant centers and they both feel that your liver is fine.  I think that you just have force yourself to accept that your liver is fine and keep working with your doctors to identify the reason for your physical symptoms.
Helpful - 0
446474 tn?1446347682
If you are still chronically infected with hep C, yes your liver disease will get worse over time as the virus replicates and creates more damage to the liver.

"feel cold ,bloated, very anxious and scared, pain everywhere and nauseated all the time."
These are not symptoms of cirrhosis as I am sure your doctors have said. What is causing them can only be determined by a doctor as many things can cause such symptoms.

Most people who have early cirrhosis without portal hypertension have no symptoms other than fatigue. It is usually only when folks have developed portal hypertension that they develop symptoms from their cirrhosis.

Your transplant center should be able to determine what is causing these symptoms even if they are not related to your liver disease. They can always refer you to a specialist at the hospital in the area of what they think the issue is.

What stage of liver disease to you have according to a recent biopsy?

The ultrasound would have indicated a cirrhotic liver with nodular growths, enlarged spleen, enlargement of the portal or splenic veins with portal hypertension and any fluid buildup in the abdomen (bloated) if you had complete cirrhosis. Ascites is not bloating that may happen after eating a meal. Ascites is fluid that builds up over time and does not go away in a day or a few days unless a patient has paracentesis (draining of fluid using a needle).

I am sure the transplant doctors will get to the bottom of this. An MRI will tell them if there is any abdominal related issues.

Good luck!
How you get to the bottom of this very soon.
Helpful - 0
446474 tn?1446347682
I didn't know the information about being SVR after treatment.

Once you are cured of hepatitis C your liver will begin to heal itself. Your liver disease will not get worse but better over time. It is functioning perfectly fine now as shown by your lab and ultrasound. Without hepatitis C and no signs of cirrhosis, I agree with advocate, I would look elsewhere (not HCV or liver disease) for the cause of your symptoms.
I would also be happy that you don't have either hep C or advanced liver disease.

Helpful - 0
1084115 tn?1385228589
thank you both so much for your answers.

i really hope they can find the cause of my symptoms,even when this means i have to face bad news.
i really believe my end is near,and with all the pain and nausea its even more worse.
the anxiety is eating me up,i feel like iam 24/7 on high alert mode.cant relax cant sleep,just crying and wrangle why it is like that.
sometimes i become very agressive as this condition does feel like a punishment.for me.

Helpful - 0
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