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labs

First time I have had my hands on a whole set of labs. I have already been told I need a liver transplant without one biopsy. Can anyone tell me if there is one significant thing or the combo of all these that has made that determination. I didn't get a straight answer from the doc.  

Viral load....2,100,000
Genotype....1a
ALT....79
AST....68
What other numbers are significant??? Thanks
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Avatar universal
Bill, I think our posts crossed.  Yes, I believe it was sonic bandaid who shared our opinion on the biopsy.  

Lou, all of my first post was for your benefit not sure why I addressed the first paragraph to Gauf exclusively.  
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87972 tn?1322661239
Our posts crossed- good solid advice above there. Buena suerta back atcha; sounds like really good news on the 12-week; here’s to hope it sticks.

Bill
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87972 tn?1322661239
Hi Lou-

The following values are essential:

Serum Creatinine
Total Bilirubin
INR

Here is a MELD calculator that will allow you to enter the above values and help you determine a MELD score (MELD stands for Model End Stage Liver Disease).

http://www.thedrugmonitor.com/meld.html

I strongly disagree with the thoughts of others regarding the need for biopsy. Once a person’s liver begins to decompensate, biochemical markers are not only sufficient to prove ESLD, the risk-benefit ratio for biopsy just isn’t there. Why subject a patient to biopsy risk just to prove something we already know? Biopsy results don’t factor into the MELD score, and your platelets are suppressed to the point where the risk for bleed is substantial.

Jeez, sorry to hear your going through this. We have a few transplant survivors that post here regularly; Mikesimon being one of them. They might have more insight than most of us in here.

I wish you well, and take care-

Bill
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Avatar universal
Gauf, I am imbetternow's friend that is post transplant.  He is right, I saw 2 Hepatologists at 2 different research hospitals.  Both institutions told me no biopsy necessary.  I did already have ascites, the bloating and swelling around the ankles.  On top of that I had varices, blood vessels in the esophogus that "balloon" and are very dangerous.  After putting these symptoms together with my labs, I had ultrasound to listen to my hepatic artery.  The sound told the doctors the liver was not allowing the blood to flow through it due to cirhosis.  My alt/ast told of inflammation and creatinine, bilirubin and INR/PT told of my stage.  At that time I was told stage 3, but without a biopsy.  6 months later it had progressed to ESLD (end stage liver disease) and I would be evaluated for a transplant.

Your labs don't look all that bad for now, so I would take a deep breath and see another doc for a second opinion.  I had to for insurance purposes.  There are probably 5 transplant residents her on the forum that will toss in and help you begin to understand the journey and the decisions you will have to make.  

By the way, I am treating with soc and was undetected at 12 weeks.  I am currently finishing week 42 of 48.  I am very thankful for my docs and this forum in getting me through this!

the best to you...mike


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Avatar universal
hey man, how are you doin'...

have you had you 4 week eot tma?  buena suerta on that one!
mike
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Avatar universal
My buddy got a transplant without a biopsy. He hit a transplant list and waited. Dr's did not want to poke a hole in his already damaged and failing liver. Labs and other symptoms were enough. He dealt with ruptured veins in his neck and was airlifted to the hospital for banding.

Gauf, he got his new liver several years ago. He is a new person! He is HCV positive and in a post-transplant clinical study with combo therapy. He's und.

Don't give up. A second opinion is not a bad idea but he got a transplant and never had biopsy.
Again, don't give up. Make up your mind as to what you want to do and run with it.
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Avatar universal
u definately need a 2nd opinion..i would say..  Cause my glucose is high and alt 71 and ast 46 aand IGM 278.. wondering billiruben normal.. GET BIOSPY!!!
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173975 tn?1216257775
I agree.  

I would definitely get a second opinion AND a biopsy.

Wyntre!
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Avatar universal
sorry you are going through this. some of the labs and what you wrote most likely indicate cirrhosis but no doctor can say you need a transplant without a biopsy. GET A NEW DOC ASAP.
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Avatar universal
And no...no prevelant jaundice. I do have the spider things on hands and forearm. Bloated stomach, and ever so often I get the swollen knees and ankles.
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Avatar universal
Thanks... I haven't seen where the bilirubin count is.

Platelets 60
albumin 3.1
Creat 0.8
AFP 10.5

Some other stuff he scribbled... cirrohsis (571.5) GCP (255) TCP(287.4)
And NO... no liver biopsy ever.
Helpful - 0
144210 tn?1273088782
Liver transplant without a biopsy!!??  That can't be right. You have hep c for sure. Any jaundice? What is your bilirubin count. Give all info you can.
Helpful - 0
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