Cardiac Death Occurs. The term dcd (donation after cardiac death) means the donor died of cardiac failure rather than brain death. In either case the donor suffered an irreversible brain injury and are kept alive by mechanical life support. The dcd donors also undergo a period of low blood pressure when taken off life support and their organs may sustain further injury. Properly selected dcd organs can work fine.
More postop problem. Dcd stands for "donation after cardiac death". During the procurement the liver is subject to prolonged periods of warm ischemia which often translates into higher ischemic injury of the graft and higher complication rates post transplant. The most feared complication following dcd transplant is ischemic cholangiopathy which occurs in up to 1/3 of the cases. Re-transplant is often necessary.
Are there different levels of hepatic encephalopathy? Is the condition reversible if liver transplant is ruled out?
Yes. There are 5 stages of hepatic encephalopqthy. It is treatable even if transplant not an option. Ask the transplant hepatolgist (the liver doc) to help with this problem.
Yes. Encephalopathy is graded from 1 to 4. Reversible causes include infection, bleeding and meds. Encephalopathy related to liver failure requires medication, especially if transplant is not on option. Common treatments include lactulose and rifaximin.
Yes, can be. Encephalopathy has 4 stages, diagnosed clinically. There is one more non-clinical stage, which needs special testing. Encephalopathy can be reversible with transplantation. In some cases, it may take time. Rarely, encephlopathy can occur without liver diseses. In that situation, transplantation may not be always the option. Correcting the problem can reverse encephalopathy.
Long answer! And far too lengthy for this space. Check out this website http://digestive. Niddk. Nih. Gov/ddiseases/pubs/livertransplant_ez/#1 for all the details.
Multiple steps. First you get evaluated by a transplant center. Then you can have a living donor transplant or a deceased donor transplant. Living donors can be scheduled but for a deceased donor you must wait your turn for a matching donor. Your old liver is removed and the donor liver, either a full liver from a deceased donor or a partial liver from a living donor is attached to your blood vessels and...
Continued. Bile duct. After surgery you have to recover from the operation. It is a big operation. The operative time is anywhere from 5 to 24 hours. Afterwards you will be on immunosuppression medication forever. There are a number of complications associated with the operation and the aftercare.
It works very well. A patient needing a liver transplant typically suffers from a combination of liver failure (jaundice, poor blood clotting, malnutrition) and complications from cirrhosis (varices, low platelets, fluid build up, encephalopathy). Liver transplant replaces the cirrhotic liver and in the process removes all the complications of cirrhosis and restores normal liver function.
Replacement. An organ transplant or liver transplant is a surgical procedure to remove the damaged or diseased organ (liver) and replace it with a healthy organ (liver) from a donor patient. The organ may be donated from a living donor or a recently deceased donor patient.
Replace sick liver. The concept of transplantation of any organ is quite simple - replace the failing organ with a normally functioning organ. In the case of liver transplantation, you simply remove the diseased liver and replace it with a healthy liver from an organ donor. The new liver takes the place of the diseased liver (orthotopic) and starts functioning as soon as blood flow is restored. Sewn into place.
When. There is development of a large cancer or multisystem failure.
It depends on the cause of the need for liver transplant and the transplant center, but generally, 90-95% of patients are alive at 1 year, 75-85% at 2 years and 65-75% are alive at 5 years. This is much better than the life expectancy without a liver transplant.
Depend on severity. Prognosis of liver transplant depend on risks factor, severity of the cirrhosis, age factor, levels of ascites, levels of hepatic dysfunction.
Usually excellent. Liver transplantation should only be performed for those expected to survive at least 3 years, one of the us government's key outcome measures for transplant programs. Two categories of liver disease are generally linked to a worse prognosis because they can recur (come back) - cancer and hepatitis. Other patients should do well provided they take their medications and follow good health habits.
Be the sickest. Emergent livers are allocated to those with an expected life span of <7 d such as those with acute liver toxicity. Urgent donation is available for those very ill patients on life support. A patial liver from a live donor can be used in an urgent or emergent situation though this is controversial.
Talk with doctors... See transplant doctor to clarify if gynecomastia is really liver-transplant related. If so, ask her/him if something can be done. For someone after liver transplant, I would be more careful of any drug use. But as a urologist, I do know low-dose of radiation to the breasts helps decrease their size in patients under hormonal rx for prostate cancer. So, this may be a worthwhile consideration...
Medications. If you had a liver transplant and part of the treatment post operatively was the drug cyclosporine, then Cyclosporine (csa)-related gynecomastia 6 and 10 months after transplantation is common. Switch to tacrolimus, it does not cause the reduced testosterone, increased prolactinand lh hormone associated with cyclosporine. This will result in resolution of your gynecomastia.
Will be cured. From the disease, that required liver transplant. Liver is the main (only) source of blood proteins, detoxifies and eliminates certain chemicals, has vital roll in bilirubin ; bile salt metabolism etc. Only organ one can donate, part of it, and save a life, thousands are on waiting list.
Many causes. Liver transplant is meant for replacing the liver which is damaged from one of many probable causes; it could be from excessive alcohol intake or disease processes on which you may not have control.
Liver failure. Liver transplantation is for irreversible liver failure, most frequently for cirrhosis (when the liver is scarred beyond regeneration) or for fulminant liver failure (example: Acetaminophen overdose).