'What do you think his long term prognosis is?'
Only a hepatologist can evaluate that.
Yes, he needs a liver transplant and he should be listed ASAP!
You should find that nearest liver transplant center and have his doctor or you should setup up an appointment to be evaluated for a liver transplant soon. Waiting is very dangerous!
Hopefully he has stopped drinking. As many transplant center require 6 months to 1 year abstinence from alcohol to be listed for a liver transplant.
I am afraid you husband is very ill and will need a liver transplant soon in order to continue living. The complications he is having such as vomiting blood can be life-threatening.
'He has lost 50 lbs, lost hair in the back of his head- bald patches, seems very malnourished- dry dry skin etc. '
These are all complication from advanced liver disease.
Hasn't someone told you all this before?
'fluid in his lungs' = Hepatic Hydrothorax
The vast majority of patients with hepatic hydrothorax have end-stage liver disease. Hydrothorax is uncommon, and is found in 4–6% of all patients with cirrhosis and up to 10% in patients with decompensated cirrhosis. Although ascites is usually present, hydrothorax can occur in the absence of ascites. Most of them require liver transplantation. Until the performance of transplantation, other therapeutic modalities should be applied in order to relieve symptoms and prevent pulmonary (lung) complications
Whoever did his TIPS procedure knows his liver is failing and without a transplant his prognosis is poor. TIPS is not done for any other reason but very advanced liver disease.
I would call a transplant center tomorrow. Time is of the essence. Many complications of advanced cirrhosis can be fatal.
Best of luck.
I am currently waiting for a life saving liver transplant.
Hello Kathyboo and welcome to MedHelp!
I am sorry to hear about your husband’s condition. I too have alcoholic cirrhosis. Diagnosed in March 2010.
What is TIPS?
Transjugular intrahepatic portosystemic shunt or (TIPS) is a shunt (tube) placed between the portal vein which carries blood from the intestines and intra-abdominal organs to the liver and the hepatic vein which carries blood from the liver back to the vena cava and the heart. It is used primarily in patients with cirrhosis in which the scar tissue within the liver causes partial blockage of flow of blood passing through the liver from the portal vein to the hepatic vein. The blockage increases the pressure in the portal vein, which is called portal hypertension. As a result of the increase in pressure, portal blood flows preferentially through the branches of the portal vein to veins coming from abdominal organs that normally drain into the portal vein. These organs connect with veins that do not empty into the portal vein and thus bypass the liver. Thus, much of the flow of blood bypasses the liver. If these veins going to the other organs enlarge, they are referred to as variceal veins or varices. Varices that form in the stomach and esophagus may rupture and bleed. This is most like what took place the night your husband was rushed to the hospital.
Stage 4 grade C is the final stage of cirrhosis but it is very possible to survive for many years. Let me explain to you how liver disease works, the short version.. Everything we ingest kills off liver cells but this is okay because this is how the liver works and it has an amazing ability to heal itself. Problem is when we abuse alcohol it kills off massive amounts of liver cells and the liver cannot produce new ones quick enough so scar tissue begins to form. We first call this fibrosis and in more severe cases cirrhosis. I cannot stress to you enough how important it is for your husband to maintain his sobriety for the rest of his life with no exceptions. Otherwise his disease will continue to advance and the outcome will be fatal.
Cirrhosis commonly occurs in two stages, compensated and decompensated. In first stage of liver damage, the liver still has the ability to function normally or compensate for the damage. When extensive damage occurs and the liver can no longer function normally, decompensation occurs. You can read more about decompensated symptoms at http://www.livestrong.com/article/210239-decompensated-liver-disease-symptoms/
Decompensated symptoms in many cases can be treated but as the disease progresses they will become more severe and unmanageable. Treatments involve medication, diet, exercise and abstinence. The objective is to stop any further advancement and the areas of the liver that are not permanently damaged may recover. Although it is possible the amount of damage is too great and the liver cannot recover in which case liver transplant should be considered.
Regardless it is important your husband registers with a transplant center in order to receive the best treatment available. This does not mean he needs a transplant but quality of treatment he will receive will far outweigh treatment from any other facility no matter how good the intentions.
Since your husband has had the TIPS procedure it is important you both learn about Hepatic Encephalopathy (HE). http://www.nlm.nih.gov/medlineplus/ency/article/000302.htm
So as you can see there are many variables to consider and everyone’s body will react differently making prognosis near impossible to make at this point. I hope this helps you out, there is a lot to learn about cirrhosis and it will be important you both are active in learning as much as you can. Please feel welcome to post as often as you like and our members will be glad to help! I hope the best for you both!
Thanks so much for your reply. I have been researching cirrhosis and feel I am becoming very knoweldgable at this point. I did want feedback from some that have been thru this, and I appreciate it so much. I do have a question... can he register on a list if it has been under 6mos since he stopped drinking? He quit drinking right before we had to call 911, so it has been just about a month. Dont we have to wait until he has been sober for 6mos to get on a list?
I know quite a bit about cirrhosis. I wanted to get opinions from others who have been thru this. Thanks for your input
his bilirubin has been dropping, was 3 now it is 2.8. Do you know if this is high bilirubin?
He can register with the transplant center and begin treatment it will be up to the center to list him if and when they feel it is necessary although they will not list him until he has six months of documented sobriety. When a person is first diagnosed with alcoholic cirrhosis you will see the most improvement in the beginning since the source (alcohol) causing the damage has been removed. After that hopefully what your left with is a liver capable meeting the body’s needs.
Another idea to consider is with ever blood lab test or imaging test request a copy. There is normally no charge. Bring home the lab results and place them in a folder and repeat with every test. Get familiar with how to read the test and what each item means. Compare one to the last and set a reasonable goal to change the results to bring it back in to range. This can be done through diet and exercise. It can be quite rewarding at times and he is the one to benefit. You can even go as far as to create a spreadsheet like I have done here to gain a better overview of his condition. http://www.medhelp.org/user_photos/show/308346?personal_page_id=1830091
You seem very motivated and that’s great! You’re on the right track. Take care,