Aa
End Stage complications
Hi,
This is the first time writting to this site ( or any site). I was diagnossed with HEP C close to three years ago. At that time the dr.s estimated 25 to 30 years ofr exposure to the virus. Discovery came during gall bladder removal ....in any case I did an extended time ( 57 wks) on treatment and could not sustain a negative....but now I have blood counts and complications that prevent me from trying the newly released drugs. Because of the portal hypertention causing bleeding. , the drs have made a recomendation to insert a shunt to let some of blood bypass my damaged liver. Will return to dr.next week to finalize options and I am being worked up to be added to the transplant list.....my question is, are there any readers out there that have had this procedure? I was told that the procedure was only temporary to buy time until a possible transplant
Thanks
This is the first time writting to this site ( or any site). I was diagnossed with HEP C close to three years ago. At that time the dr.s estimated 25 to 30 years ofr exposure to the virus. Discovery came during gall bladder removal ....in any case I did an extended time ( 57 wks) on treatment and could not sustain a negative....but now I have blood counts and complications that prevent me from trying the newly released drugs. Because of the portal hypertention causing bleeding. , the drs have made a recomendation to insert a shunt to let some of blood bypass my damaged liver. Will return to dr.next week to finalize options and I am being worked up to be added to the transplant list.....my question is, are there any readers out there that have had this procedure? I was told that the procedure was only temporary to buy time until a possible transplant
Thanks
Best Answer
Thanks to all for sharing of information, thoughts, prayers and words of encouragement following my posting on 1/11/12.
John
John
Best wishes in finding out options. Sounds like you are in the hands of a good hepatologist. Keep us posted.
Advocate1955
Advocate1955
just want to say I wish you a positive outcome & thoughts & prayers are with you.............really...miracles are all around us.........take care
Welcome to the forum. I'm happy to hear that you have a proactive Dr and are getting good options. You've had a lot of experience so you know the ups n downs. Best wishes to you at this stage in your journey.
Karen :)
Karen :)
Hang in there. I had a transplant and am doing well.
If I can do it, you can too.
Good luck,
OH
If I can do it, you can too.
Good luck,
OH
Welcome to the community. I wish you the best in getting a transplant soon. If you don't mind. What is your MELD score? At what MELD score is your Transplant Center transplanting at?
As you said you are too ill to treat your hepatitis C any longer. You will probably be treated again after you recover from your transplant.
TIPS (Transjugular Intrahepatic Portosystemic Shunt) is a procedure performed by a IR (Interventional Radiologist) to manage advanced portal hypertension and some of its complications. It is used when medicine can no longer manage ascites and bleeding of varies. Both which can be life-threatening complications of End-Stage Liver Disease (ESLD). It is one of many treatments that help a patient to survive until transplant. The term used is it is a procedure used as a "bridge to transplant". A few of my friends had the the TIPS procedure while they were waiting for a transplant. I am also on 2 transplant lists and have ESLD and liver cancer.
"I was told that the procedure was only temporary to buy time until a possible transplant."
That is correct. When you receive your new donor liver it is no longer needed.
Why is TIPS needed:
Portal hypertension is a complication of cirrhosis which causes many of the common complications of advanced liver disease. When the liver becomes more and more scarred the natural blood flow up from the the stomach, the intestines, the spleen, the gallbladder, and the pancreas into the liver is reduced and finds collateral veins to return to the heart. "Caput medusae" is caused by this. The dilated veins seen under the skin of the abdomen of a patient with cirrhosis of the liver. When even these veins cannot handle the blood pressure another path must be created to allow the blood to flow. This is what TIPS does.
The one common common complication of having TIPS performed is it usually will increase the degree of Hepatic Encephalopathy a patient has. So if you have HE, which most patients with ESLD caused by hepatitis C have. They may have you increase your dosage of lactulose to manage the symptoms. The benefit of preventing future bleeds is well worth the increase in HE as most of us have HE chronically anyway.
Here is more detail about the procedure...
"How is TIPS performed?
Typically the procedure takes between 1-2 hours. Upon admission, the Interventional Radiologist will explain the procedure to you and your family and ask you to sign a consent form stating that you understand the procedure you are having. This is a good time for you to ask questions and share any concerns you may have. Once the consent is signed, an intravenous line (IV) will be placed in your arm to help you relax and give you medications needed during your procedure.
During your TIPS, a needle is first placed into your right jugular vein-—a large vein in your neck—-and threaded down through your superior and inferior vena cava to the hepatic vein. A catheter is then threaded over the needle and pushed through the hepatic vein and liver into the portal vein. A small balloon (associated with the catheter) is then inflated to enlarge the pathway between the hepatic and portal veins. A mesh stent is inserted between the two veins. This stent will stay in place permanently until your liver transplant at which time the entire liver, including the stent, is removed and the new liver is put in place.
What do I do after my TIPS?
After the TIPS procedure, your right neck catheter will be removed and the site will be checked for signs of bleeding. You will be monitored in the hospital for 24 hours. An abdominal ultrasound will be performed every 3-6 months following your TIPS procedure to assure it is functioning properly."
Best of luck to you. Hope you get a transplant soon!
Hector
As you said you are too ill to treat your hepatitis C any longer. You will probably be treated again after you recover from your transplant.
TIPS (Transjugular Intrahepatic Portosystemic Shunt) is a procedure performed by a IR (Interventional Radiologist) to manage advanced portal hypertension and some of its complications. It is used when medicine can no longer manage ascites and bleeding of varies. Both which can be life-threatening complications of End-Stage Liver Disease (ESLD). It is one of many treatments that help a patient to survive until transplant. The term used is it is a procedure used as a "bridge to transplant". A few of my friends had the the TIPS procedure while they were waiting for a transplant. I am also on 2 transplant lists and have ESLD and liver cancer.
"I was told that the procedure was only temporary to buy time until a possible transplant."
That is correct. When you receive your new donor liver it is no longer needed.
Why is TIPS needed:
Portal hypertension is a complication of cirrhosis which causes many of the common complications of advanced liver disease. When the liver becomes more and more scarred the natural blood flow up from the the stomach, the intestines, the spleen, the gallbladder, and the pancreas into the liver is reduced and finds collateral veins to return to the heart. "Caput medusae" is caused by this. The dilated veins seen under the skin of the abdomen of a patient with cirrhosis of the liver. When even these veins cannot handle the blood pressure another path must be created to allow the blood to flow. This is what TIPS does.
The one common common complication of having TIPS performed is it usually will increase the degree of Hepatic Encephalopathy a patient has. So if you have HE, which most patients with ESLD caused by hepatitis C have. They may have you increase your dosage of lactulose to manage the symptoms. The benefit of preventing future bleeds is well worth the increase in HE as most of us have HE chronically anyway.
Here is more detail about the procedure...
"How is TIPS performed?
Typically the procedure takes between 1-2 hours. Upon admission, the Interventional Radiologist will explain the procedure to you and your family and ask you to sign a consent form stating that you understand the procedure you are having. This is a good time for you to ask questions and share any concerns you may have. Once the consent is signed, an intravenous line (IV) will be placed in your arm to help you relax and give you medications needed during your procedure.
During your TIPS, a needle is first placed into your right jugular vein-—a large vein in your neck—-and threaded down through your superior and inferior vena cava to the hepatic vein. A catheter is then threaded over the needle and pushed through the hepatic vein and liver into the portal vein. A small balloon (associated with the catheter) is then inflated to enlarge the pathway between the hepatic and portal veins. A mesh stent is inserted between the two veins. This stent will stay in place permanently until your liver transplant at which time the entire liver, including the stent, is removed and the new liver is put in place.
What do I do after my TIPS?
After the TIPS procedure, your right neck catheter will be removed and the site will be checked for signs of bleeding. You will be monitored in the hospital for 24 hours. An abdominal ultrasound will be performed every 3-6 months following your TIPS procedure to assure it is functioning properly."
Best of luck to you. Hope you get a transplant soon!
Hector
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