Regrowing part of a liver

[nuhepper]

Herman Cain, when running for president said he had had liver cancer.  They cut out the part that was cancerous and the his liver regrew to normal size and function.  Can they do the same thing with a liver that has spots of cirrhosis?

[frijole]

Big typo -- yes. can-do - you can read my mind, as usual.   We have known each other way too long.  That can be mighty dangerous'

But good, I am glad to see that you will be taking 1000 riba

On the topic of liver transplant.  I don't think it is anything any one of us would do if our liver was compensated.  A compensated cirrhotic liver probably will give less problems in the long run than a transplant, requiring lifelong monitoring and anti-rejection medication daily.  

Ceanathus, I am glad to see you here.  I too don't make it by nearly enough lately.  My plan is to get a liver biopsy next year.  I know that they say there is no reason, but I really do want to know if any damage has been reversed by SVR.  I was grade 3-4 inflammation and stage 3 & 4 (and the doctor said about 50/50) with fatty liver too.  I have only been diagnosed with cirrhosis since 2011.  I  hope you do have SVR (I am confident) and I hope our livers can heal.

nuhepper - there are more genotype 1's in the US.  I read that genotype 2&3 account for about 20-25% in the US.

"Genotype 1 is the most common type of Hepatitis C genotype in the United States and the most difficult to treat. For physicians, knowing the genotype of Hepatitis C is helpful in making a therapeutic recommendation. Individuals with genotypes 2 and 3 are almost three times more likely than individuals with genotype 1 to respond to therapy with alpha interferon or the combination of alpha interferon and ribavirin. Furthermore, when using combination therapy, the recommended duration of treatment depends on the genotype. For this reason, testing for Hepatitis C genotype is often clinically helpful. Once the genotype is identified, it need not be tested again as genotypes do not change during the course of infection.

[nuhepper]

Not a problem RK,

Would it be true that there are fewer Genom 3's than 1's.  Have you been on the rib and peg treatment for all 36 weeks?  How has the tx been to deal with?  How much longer to EOT?

Nuhepper

[nuhepper]

Our livers may not be the greatest, but our heads are still on straight :-)

When you are SVR, why couldn't you get a whole liver transplant or a partial transplant from a living donor that they say will grow to full size in a few weeks?  It is normal procedure to take the whole damaged liver out and replace it with a partial one from a contributer.  The partial one will grow to full size in a few weeks.  

You have been through a lot.  Take a break and watch for more progress.  I would guess that if your body doesn't have the strain of fighting the virus anymore that it could apply itself now to healing the damaged liver.

Please understand that I don't KNOW anything.  Just started asking questions a couple of days ago and reading wherever it leads.  

Thank you so much for sharing.  It is good to combine thoughts and ideas.

Please stay in touch.  Hope you get the best news in two months.

nuhepper

[ceanothus]

I'm late to this thread, but I've had similar thoughts for some time now. I've had full-on stage 4 cirrhosis for 9 years now. Thankfully it has remained compensated and, even more thankfully, I've been able to complete 48 weeks of triple tx with apparent success (will know for sure in 2 more months). So hopefully the virus is gone, but I'm still left with a badly damaged liver which, according to standard wisdom, will not regenerate itself. So I have been wondering: if a person can donate half their liver and regrow it again, what would happen to my damaged liver if they removed part of it? If the virus is gone then I don't see why it would necessarily not regrow, or why it would regrow in its damaged format. I mean, the genetic structure that tells it to regrow should still be there, and if the virus is gone, then why wouldn't it grow according to its genetic instructions? I can imagine that this may be considered too risky to even research it, but I do still wonder if it might be a possibility in the future. It may be just wishful thinking, but I choose to keep hoping.

[rk2761]

Hey nuhepper. Sorry I gave you incorrect information about the liver regrowing. Thanks to all for providing correct information.

rk

[can-do-man]

That was a typo by frijole as she meant 800mg... Good luck

[nuhepper]

Makes me feel better too.  It is so much better to see a light at the end of the tunnel.  But, they said there are only spots of stage 4.  The rest is just stage 3 and the inflammation is at stage 2.  None of the Pro's have said anything about a fatty liver factor.  But based on my research, it may be a main cause for the condition my liver.  We are taking measures to deal with the fatty liver.  It certainly can't hurt to be on a healthy, healthy diet. As far as we can tell, thats all the Pro's will prescribe is diet and exercise for a fatty liver.

nuhepper

[nuhepper]

He changed my prescription of rib from 800mg to 1000mg even before starting the tx.  That would be a long way from 80 mg.  I wonder what is up with that.  

nuhepper

[uncledudeness]

my Dr at Yale told me that the consensus in the liver biz was that once the liver advanced to stage 4 that no healing was possible. he said that they are starting to believe that this is not true. :there is some degree of 'healing' relative to compensated cirrhosis". i think that's what he said. it made me feel a bit better.  

[frijole]

Smart move, changing doctors.  So today must be the day.  I hope you have a smooth start.  The treatment is something that can be tolerated (not loved, but tolerated) and hopefully you will eradicate the virus.  Since you are a G3, what stance is the hepatologist taking on Ribavirin.  In the past the dosage was 80mg no matter what, but now I think more doctors are using weight based dosage and I think this is more appropriate.  Also, ask for a VL test at week 4.  This also was not the old protocol, but it is a critical date to get tested and may impact treatment decisions later on.

[Dee1956]

Good luck with your tx, I hope you stick around to let us know how you are doing
My best to you
Dee

[HectorSF]

Best of luck with your treatment!!!

Hector

[nuhepper]

Hi frijole,

Yes the surgeon did a biopsy when when he took out the gallbladder.  Previos to that, my blood test revealed Hep C / Genom3. I will be starting Rib and Peg tx tomorrow.  So far the Gastro Doctor has down played my chances for full recovery (great health).  I wasn't satisfied with that and have already changed to a Hepatologist / Gasto Doctor that even has time to see me.  With what I have learned from my new friends here, I have hope of full recovery.  ;-)

Thank you for sharing,

nuhepper

[frijole]

When they took out your gall bladder, did they do a liver biopsy?  Had you had one before that showed stage 3?  In my opinion once those regenrative nodules are forming you better get busy.  The disease is distributed throughout the liver as others have said, even if the doctor only saw "a few nodules" when he took out your gall bladder.  Your best bet is to treat the hep C, not go in for more surgery.

frjiole

[nuhepper]

Yes.  And that is the plan now.  Now that I have been schooled to believe that after the tx the liver will likely repair itself.  

nuhepper

[copyman]

Don't think you could even find a doctor that would cut out the cirrhosis spots as you call them. It just isn't a reason for serious operation like that.

Better to cure the cause of cirrhosis then with the right diet & exercise let the liver repair itself.

[nuhepper]

Thanks for the great input and links.  I will search them out right away. You, can-do-man and HectorSF have given me a goal to aim for.   My tx starts tomorrow morning.  No side effects yet other than nervousness.  :-)

nuhepper

[rodian]

http://www.sciencedaily.com/releases/2010/06/100607065856.htm

The singular mechanisms of liver regeneration
The liver is a very special organ: even if more than 50%
percent of its overall mass is damaged
it can regenerate itself completely

http://onlinelibrary.wiley.com/doi/10.1002/hep.20969/pdf

During liver regeneration after partial hepatectomy, normally
quiescent hepatocytes undergo
one or two rounds of replication to restore
the liver mass by a process of compensatory hyperplasia.

A large number of genes are involved in liver
regeneration, but the essential
circuitry required for the process may be
categorized into three networks: cytokine, growth
factor and metabolic.



Liver regeneration
Scientific and medical literature about liver regeneration often alludes to Prometheus and the devouring and daily regrowth of his liver.
Some think  the myth even indicates that the ancient Greeks knew
about the liver’s remarkable capacity for self-repair.


http://en.wikipedia.org/wiki/Theft_of_fire
“The immortal Prometheus was bound to a rock, where each day an eagle,
the emblem of Zeus, was sent to feed on his liver, only to have it grow back to be eaten again the next day.”

[HectorSF]

Of course you are correct. Stage 3 liver disease is reversible and there are no regenerative nodules to begin with.


Hector

[can-do-man]

Hi Hector, don't you agree that really with nuhepper thats all mute anyway as he is just stage 3, maybe late 3 but still he really has no worries once he becomes SVR. His liver should heal enough that that he will never have any problems... Myself as an established stage 4 more then likely will not have any problems unless I decide to abuse my liver...

Hope you start moving up on that list soon guy............

[HectorSF]

Mr. C had colon cancer not liver cancer by the way. Just to set the record straight.

H

[HectorSF]

Great my post was deleted.  But short and sweet...

'spots of Stage 4' are never cut away. The only spots from stage 4 liver disease are 'regenerative nodules'. Cirrhotic livers are characterized by advanced fibrosis and the formation of hepatocellular nodules which distorts the architecture of the liver. Regenerative nodules form in response to necrosis, altered circulation, or other stimuli. Regenerative nodules also may be classified according to size as either micronodules (<3 mm) or macronodules (≥3 mm). If you have seen an explant (a liver surgically removed you will see its surface is covered with these nodules and is no longer the shiny smooth liver that people have without liver disease.

Just Google 'cirrhotic nodule regeneration' and look at images for pics of nodular cirrhotic livers.

The regenerative nodules are distributed throughout the entire liver so to cut them our would be to cut out all of the scarring around the liver lobules. That would destroy the liver.

As someone said when cirrhosis becomes very advanced the liver is no longer repair itself as only a small percent of the liver is actually functional.

The only things that are cut out of cirrhotic livers are tumors and benign masses that go to a size that they create problems.

Hector



The regenerative nodules of hepatocytes are surrounded by fibrous connective tissue that bridges between portal tracts.

[nuhepper]

Thank you so much!!!  And thanks to HectorSF and Idyllic.   You are all so kind.

nuhepper

[can-do-man]

From Doctor D here.

http://www.medhelp.org/posts/Hepatitis/Recovery-of-Fibrosis-and-Cirrhosis/show/534318