Liver Cirrhosis - YHK Treatment

[CKV82]

Hi,

My mother (56 years old) was diagnosed with decompensated liver cirrhosis in Sep'12. She was hospitalized for 3 weeks and then she is currently taking diuretics, lactulose medicine & low sodium diet. She has certainly improved but doctors are saying she has to undergo liver transplant as her liver is damaged and the improvement is not so good. She is in regular medical check up and the stage of liver cirrhosis is Child C - MELD 11. As liver transplant is a complicated one, my family is worried about her condition. We were looking for an alternate medicine and we have just come across this in internet (link below). It is very encouraging and give a new hope as they promise good results without any side effects. Can someone suggest me if we can go for these tablets, will it be a good idea at this stage? Please give your opinion on this.

www.yhktherapy.com
www.pubmed.gov

Thanks.

[ManishK]

I need your advice to avoid any liver related complications in the future. Kindly suggest me the way to avoid HCC in the future, frequency of MRI/AFP and if any medications required to overcome CHB.

Patient Details
Manish, Male, Age – 33, Currently on Tenofovir 300 mg
HBV DNA -   ,   HbeAg -   , Anti Hbc + , HCV -
Patient Health - Very Normal (Working 8 hours daily)

Patient History
-          CHB (Got to know in 2013), Later Family History of HCC

-          LFT – Normal so far, (Latest: SGOT – 26, SGPT – 27, Alkaline Phos - 103)


-          Weight – 59 Kg, No weight loss

-          HBV DNA Negative till now.

-          AFP – 3.8

-          Fibroscan (10/05/2016) -  LSM – 5.9 +- 1.5upa, Cap – 220 +- 13 d3/m

-          Endoscopy – Normal (30-Jul-2013)

-          Liver Biopsy (14/09/2013) – focal evidence of macrovesicular steatosis, limited to zone 3 (< 10%) with focal spotty necrosis, no significant fibrosis, Grade (HAI) = 2/18, Stage – 0/6, Possibility of NASH Could not be ruled out.

Evion 400, UDA – 300mg, Nusam – 400 mg for 3 months

Peg IFN Alpha 2B + Tenofovir (48 Weeks) – 27/06/2015 to 28/05/2016
-          Peg IFN started as CT (Aug - 2015) Seg 6,8 has small foci lesion seen. HCC Ruled out.

-          Genotype – D

-          HbsAg Quantitative History

27-06-2015 (Before Peg IFN started) – 6537

12- 12-2016 (Within six month of Peg IFN) – 3756

05-10-2016 (After 5 month of Peg IFN completion) - 4258

PEGIHEP – 100 (Zydus Cadilla) – First six months
PEGVIR – 100 (Cipla) – Last six months

Latest MRI Report (27-08-2016)

No HCC
Chronic liver disease with multiple subcentrimetric arterial enhancing lesions in segment VI, VII and VIII, no washout on venous or delayed phase, no diffusion restriction likely dysplastic nodules. Compared to previous scan (before one year), new arterial enhancing lesion in segment VII and VIII.
Segment VI lesion – no interval change

MRI on Report (29-08-2015)

Small arterial enhancing lesion (5 mm in size) in segment VI of liver in the subcapsular region with no evidence of contrast washout in venous and delayed phases.

[flyinlynn]

We are a community of patients and not medical professionals. You should ask your doctor.

[Ranjan88]

GOOD NEWS for all those people who are suffering from liver disease like fatty leaver, fibrosis and cirrhosis. Galectin Theraputics successfully reversed the liver cirrhosis in preclinical trial (http://online.wsj.com/article/PR-CO-20130429-905989.html). and FDA have approved fast track designation for their clinical trials and the best part is that the Galectin Theraputics started their Phase-1 human trial on fast track and dosed the first patient in July,2013 and the phase-1 will conclude results in late 2013 or early 2014, Galectin Theraputics have made a pipeline on their website to show progress of their clinical trials (http://www.galectintherapeutics.com/programs/pipeline.php). If everything goes right then people will have a promising treatment for chronic liver disease, expecting in early 2015(assuming 6month for every trial phase). so keep looking to their site for updates (http://phx.corporate-ir.net/phoenix.zhtml?c=135403&p=irol-news&nyo=0)

[Juliemodi131]

Hi there - how is your mother doing?
My Dad is in a similar situation in India. Not sure whether liver transplantation is the only option?

[HectorSF]

Yes, I understand your concern about safety. It sounds like she has good care which is wonderful. But as you know the Indian practice of liver transplant is relatively new in India.

Is there any possible way for her to go to a develop country and somehow get health insurance? Certainly that would be less risky. Although very difficult for sure.

I am just throwing out an idea.

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Success rate low, patients seek liver swaps outside city
Menaka Rao, Hindustan Times  Mumbai, August 12, 2012

The success rate of liver transplants in Mumbai is about 50%, significantly lower than the 80% and 90% success rates in Delhi, Chennai and Hyderabad, say city doctors.


This is perhaps one reason why former Maharashtra chief minister Vilasrao Deshmukh chose to travel to Chennai for a possible liver transplant when he suffered multiple organ failure last week. This, despite the fact that the country’s first successful liver transplant was conducted at Mumbai’s Jaslok Hospital, in 1998. City doctors say they were not surprised by Deshmukh’s decision. “The liver transplant success rate in Mumbai is about 50%, which is not very good,” said Dr Pravin Shingare, joint director at the Directorate of Medical Education and Research.

In a 2010 liver transplant at KEM Hospital, Parel, for instance, both donor and recipient died after the surgery. “In two years, we have had six patients, of whom three have survived,” said Dr Chetan Kantharia, who heads the programme at KEM.

One reason for the Chennai programme’s success is the large number of cadaver donations in Tamil Nadu. Since 2008, more than 1,270 organs and tissue samples have been donated in that state, against just 300 organ donations in Mumbai in 15 years.

Since 2006, Jaslok Hospital has conducted about 34 liver transplants. By contrast, Delhi’s Apollo Hospital conducts about 300 liver transplants annually, and Global Hospital in Chennai, conducts about 150.
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Liver Transplant in India
Liver transplants in India cost only a fraction of what they do in the US. Despite the fact that the country offers the most advanced facilities and treatment options, the surgery costs are greatly reduced and the procedure costs anywhere between US $40, 000 - $60, 000. Also, there is virtually no waiting time. Leading surgeons perform liver transplants at the world renowned hospitals which are well equipped and technologically advanced. The doctors are highly qualified and much experienced, as is the staff. Also, when it comes to liver transplants, India has many successes to its credit, including liver transplant surgery in India for the youngest child and the first combined liver-kidney transplant in India.

For foreigners, only living donor liver transplants are facilitated, which requires them to bring a healthy, willing donor (a family member) with them when they come for a transplant. Cadaveric transplants are not practical for foreign nationals and also, the success rate for the former is much more.
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Global Healthcare Solutions
19, 1st street, Jeevarathnam Nagar,
Adyar,
Chennai-600020, T.N. , India.
Mobile : 91 - 9654969786
Email : ***@****

http://www.liverindia.com/liver-transplant.php

At the authors center at New Delhi more than 40 successful liver transplants have been carried out, making it the only successful, ongoing liver transplant programme in India till date. At the authors center in India the liver transplant therapy will cost approximately half the amount from other countries. Transplantation in Europe and the USA will cost 150 and 300,000 USD respectively. The waiting time in most western centers for foreigners is in order of 12 months. It is also common practice in most centers to offer livers rejected by local transplant centers as sub-optimal, to foreigners on the waitlist. So patients with adequate financial resources and ample time to wait can seek liver transplant service outside India. Unfortunately patients from India in middle-class and upper middle-class financial setting end up going abroad from poor guidance. Most of these patients will either die while awaiting a transplant or return to India in a morbid state after exhausting their finances. Remember there are more patients dying on the waitlist as compared to those who succeded in getting a suitable good liver! Hence live related donation is an important option for every patient facing the end stage liver disease state. This facility is now available at your door step at Delhi.

There are very few active liver transplant centers in Asia. Apart from author's centres in India, there are centers in Singapore, Ritadh, Istanbul, Bangkok, Seoul, Tokyo, Kyoto and Taiwan. Most of these centers in Asia suffer from the same malady of non availability of cadaver organs. They all tend to have large waiting lists of local citizens and few have time to take on foreign patients.

Centers in Tokyo and Kyoto, Japan and Seoul, South Korea exclusively carryout live donor liver transplants. The cost of liver transplant in Asia, outside author's centres will be more than 100,000 USD for a straight forward cadaver liver transplant. This of course will not include costs related to transportation, waiting, evaluation, accommodation and food.


Best of luck to you!
Hector

[CKV82]

Hi,

Thanks for your response. I totally understand your concern and I do not want to put her life into risk.
My mother is in India and she is following a balanced diet as suggested by her doctor. She is following her diet properly along with the drugs prescribed by doctor. She is going for monthly check-up and doctors have told that based on the improvement they will take a decision in June for liver transplantation.
My worry is I am not sure how successful the liver transplantation would be in India. The medical facilities have certainly improved a lot but still liver transplantation success rate is not so good in India. This is the main conern that made me to look for alternate medicine but I understand now it is risky.

[CKV82]

Hi,

Thanks for your response.
My mother is in India and she is following a balanced diet as suggested by her doctor. She is following her diet properly along with the drugs prescribed by doctor. She is going for monthly check-up and doctors have told that based on the improvement they will take a decision in June for liver transplantation.

Regarding her hospitalization, she was in UK (my home) last year and I have noticed her weight loss along with breathing difficulties. I have taken her to hospital and they have confirmed that she has got ascites. Based on CT scan and LFT, they have confirmed that she has liver cirrrhosis but the cause is unknown (cryptogenic). Biopsy was carried out but there is no cancer growth. She is continuing her medicines now and we are hoping that she will improve.

[CKV82]

Hi,

Thanks for your comments. My mother is in India and we will discuss with hepatologist first before we consider this medicine. I will let you know how it goes.

[HectorSF]

"We were looking for an alternate medicine and we have just come across this in internet "

There is NO alternative to liver transplant. Those people are preying on the weak and sick to make their money. They have no medical background and don't even understand the basics of liver disease. In fact those products can be harmful to someone with cirrhosis. Only drugs that are approved by her hepatologist should even be taken. Even over the counter pain relievers which can cause servere liver damage when taken by someone with advanced liver disease.

Your mother's liver disease will continue to get worse UNLESS the underlying cause of her liver disease is stopped from further damaging her liver. Improper care or no care and "so-called" alternative care will lead to death in time. I have known a number of people how thought the a transplant was too much to handle so they tried alternative treatments. Unfortunately none of them are alive any longer. Unfortunately that is the reality of progressive liver cirrhosis. The only people that can provide proper medical care for her is a liver transplant center. They are the only doctors and support staff that work with people with cirrhosis on a daily basis and know how to manage it so the patient suffers the least.

Yes, a liver transplant is complicated. None of us like disease and death. Unfortunately these things happen whether we like them or not. The best we can do is face the facts and deal as best we can with the circumstances. Magical thinking is just that. A fantasy. It is better to help and support your mother as in time she will become more unable to do the things she once could. She is still young and has an excellent chance for a full recovery after a transplant. Support and love is what she needs not someone giving medical advice. That is her doctors jobs. Cirrhosis is more of a mental battle than physical one. She could wait many years for a transplant depending on what transplant center she is going to. She will need lots of help and support both before and after transplant. Transplant is a life changing event and patients and their loved one go through many ups and downs. But it is doable if you take it one step and one day at a time.

Even the vast majority of physicians don't understand it. So to believe that someone that hasn't gone through medical school could understand it is wishful thinking.
Steve Jobs had billions of dollars and the power to take any medicine or go anywhere in the world to get help. He delayed his treatment by trying "natural" treatment. So even when he got a liver transplant his cancer still came back and killed him eventually. Please don't make the same mistake with your mother's life.

Good luck to you and your mom.
Hector

[rpooo]

Hello and welcome to MedHelp!

Cirrhosis is scaring of the liver and as you know scar tissue does not heal this is why cirrhosis is irreversible. A MELD score of 11 is quite a ways from needing a transplant depending on the cause and if HCC (liver cancer) is present.

This would be the miracle pill we are all hoping for and we all would be taking them. Unfortunately I believe this pill is nothing more than an antioxidant to assist the liver in removing toxins from the body. A more natural way to do this is with diet. It is very important she learn as much as she can about cirrhosis. Learn what foods and medicines are not harmful to the liver. The objective being to halt or slow any further cirrhotic advancement, this is only possible depending on the cause.

A good place to start learning is here: http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/

The most important thing for her to do is to register with a transplant center, this doesn’t mean she will for certain need a transplant but she will receive the best treatment available and be prepared if transplant is unavoidable. Any other doctor is not qualified to provide her with the treatment she deserves despite their good intentions.

Myself and other member in the community will be glad to assist and answer any questions along the way. I have a couple of questions for you and if you decide to answer I could elaborate further concerning her condition.

Why was she hospitalized?
What is the cause of her cirrhosis?
Was her diagnosis made using biopsy or CT scan?
You mentioned she has “decompensated cirrhosis”, what symptoms have manifested?

Randy

[rivll]

I find it very interesting that there was considerable research done on this product and that it is FDA approved and this is the first I have ever heard of it.

I distrust the internet and suggest you take/send copies of the research studies to your mother's hepatologist and get his/her take on it. If the Hepa approves it, go for it and good luck.
If not, don't take chances.
I am very open to alternative/natural medicine but I know what a normal person can handle and even benefit from may kill a cirrhotic. So please check with the DR.
Let us know how it goes.