Is POT bad for liver as well??

[meNtoby]

I'm recently diag. but my brother has known for 14 years that he has
HCV.  Lived in another state till recently, but i found out he doesn't
take treatments, hasn't gotten a doctor here either. He still can
drink a 30 pk of beer and might keep it up for days if he can't sleep.
I never saw any particularly horrid things (cept for his bad behavior)
but kept my mouth shut. However, I thought POT was helping him
with his anxieties, and not hurting his liver.  We don't communicate
now and he doesn't know bout my recent result. Not enough info
yet, and it may be best to keep that close to the vest there anyway.

Just wondered why the pot thing is bad. Liver detoxifying the THC?
I don't smoke it, but thought of all the things I disapproved of (silently)
that the pot was the least damaging to him.

How do HCV patients control pain if they have other diseases? I've
heard no aspirin, no nsaids, and tylenol bad too?

[mnb36]

My brother is in end stage liver disease with hep c.  hi liver has shrunken and he went into hepatic encephalopathy last week.  He was released from the hospital Monday.  He continues to smoke weed daily.  Will this damage his already small liver?  

[mikesimon]

That's hard to argue against but I do see articles discussing HCV+ organs transplanted into HCV+ recipients. I saw a kidney like that just recently. It is confusing when you look at UNOS because HIV is clearly set forth as a disqualifying disease but not HCV or HBV.
You have a great Day too Bill!
Mike

[Bill1954]

Hi Mike,

Thanks for providing the published information.

I *count* on others in here to straighten me out if I provide misleading material in this forum.

I was drawing from personal experience, which has been contrary to the info you posted above.

In 2006, I completed an ‘advance health care directive’. Along the same vein, I tried to find a facility that would accept either organ donation or whole-body donation, so my family wouldn’t have to deal with these issues when the time comes.

I inquired at my doctor’s office, which is also a west-coast TP center. They told me that I didn’t have any organs anyone would be interested in, and to check with a local university that *also* has a TP center. That TP center referred me to their whole body donation program, where my body was denied, even for research purposes. When I informally challenged the denial, I received a response that said in part:

“I have received your paperwork indicating your wish to donate your remains to our program upon your death. Unfortunately, we are unable to accept your registration at this time. All donors who come into the program are tested for HBV, HCV, and HIV and cannot be used if positive. To answer your specific question regarding long-term sustained viral response, we treat all positive results as reactive, whether or not they may pose risk of infection, as we are unable to distinguish between positives that may be infective and positives that may not (including false positives). We must reject all positive cases to protect not only the Donated Body Program staff during preparation of the remains, but also any subsequent researchers or medical students who may come into contact with the remains.”

Additionally, in their FAQ sheet:

“These conditions, if known, *will* result in a refusal:
Hepatitis B or C
Tuberculosis
Creutzfeldt- Jacob disease
HIV/AIDS
Kuru


They appeared to be very clear on their position, and you can see why I took the position I did in answering MeNtoby’s question. It appears that  UNOS or other organizations may  take a contrary view on this position; I suppose I should do a little more research *specific* to organ donation. If you hear of any information that directly addresses HCV infection, please pass it on.

Thanks again for the info, and have a great Memorial Day weekend—

Bill

[mikesimon]

I really hate to disagree with you but my understanding is that having HCV antibodies or even active HCV doesn't automatically prohibit one from being listed as an organ donor. There are very few diseases which absolutely preclude organ donation -  HIV is one. At the time of death medical experts will determine whether any tissue or organ are suitable to be used. People should not automatically assume that they cannot be listed as organ donors because they've been infected with HCV - put "organ donor" on your license because it just might really help someone and it sure can't hurt.

§121.6 Organ Procurement.

The suitability of organs donated for transplantation shall be determined as follows:

(a) Tests. An OPTN member procuring an organ shall assure that laboratory tests and clinical examinations of potential organ donors are performed to determine any contraindications for donor acceptance, in accordance with policies established by the OPTN.

(b) HIV. Standards of quality shall be adopted and used for preventing the acquisition of organs that are infected with the etiologic agent for acquired immune deficiency syndrome.

(c) Acceptance criteria. Transplant programs shall establish criteria for organ acceptance, and shall provide such criteria to the OPTN and the OPOs with which they are affiliated.

http://www.unos.org/news/newsDetail.asp?id=239



Myth No. 7. I'm not in the greatest health, and my eyesight is poor. Nobody would want my organs or tissues.
Reality. Very few medical conditions automatically disqualify you from donating organs. The decision to use an organ is based on strict medical criteria. It may turn out that certain organs are not suitable for transplantation, but other organs and tissues may be fine. Don't disqualify yourself prematurely. Only medical professionals at the time of your death can determine whether your organs are suitable for transplantation.
http://www.mayoclinic.com/health/organ-donation/FL00077

Misconceptions Keep Many from Organ Donor Consent

Q:  I've recently read several articles about organ donation and have for years placed the "organ donor" sticker on my diver's license.

However, it occurs to me to wonder if there would be any problem with donating due to my having an autoimmune disease Sjorgen's syndrome. For many years this made little difference in my life until I experienced a sever reaction to an antibiotic requiring prednisone and several courses of chemotherapy. Is there any problem with leaving the "organ donor" sticker on my driver's license?

A:  What a great and thoughtful question. The short answer is that you most definitely should keep the sticker on your license, says Margie Fischer, organ donation coordinator of the Wisconsin Donor Network. There are only two causes for absolute disqualification as a donor: any current cancer other than a primary brain tumor, and being HIV positive. As with any prospective donor, there would need to be a more thorough evaluation at the time of death.

At this time, there are more than 74,000 Americans awaiting organ transplantation, 1,500 of them in Wisconsin. Solid organs currently being transplanted include the heart, lungs, liver, pancreas, kidney and small intestine. Additionally, tissues such as eyes, bone, skin, ligaments and tendons, and blood vessels are used from donors. In 1999, more than 75,000 tissue transplants were done in the US.

Less than 1% of deaths annually present the right circumstances for organ donation, usually the result of brain death from some kind of traumatic injury. Of the 15,000 to 20,000 deaths in this category, only about 5,000 become actual donors, yielding about 20,000 organs available for transplant. Last year in Wisconsin, 151 people were organ donors.

Factors preventing organ donation include:

    * A donor card has not been completed.
    * Family members decline consent.
    * Hospital personnel do not approach the family because they fail to recognize the potential for organ donation or they do not want to cause family members more distress.

Common misconceptions often preclude the completion of a donor card. Many people erroneously believe that a cost to the family will be assessed, than an open casket would not be possible for a donor, that emergency room staff will be less diligent in life-saving efforts, or that organ donation is contrary to widely held religious beliefs.

If after considering this information you elect to complete a donor card, tell your family of your decision and wishes. If you have questions, call the Wisconsin Donor Network at [phone].

Article Created: 2001-03-07

http://healthlink.mcw.edu/article/984001017.html


Mike

[HectorSF]

Thanks Bill you are always a wealth of knowledge and support.

meNtoby yes SF is a great city in my opinion. I've been hear almost 30 years and still find it beautiful and special. Plus we have great healthcare too!

Hector

[meNtoby]

Thank you, Bill, I'll leave the organ donor scratched out.  Possible candidate for part of my liver should I become SVR, should I have PCR #s, would be my brother, who is very
cavalier (sp) about his HCV, and parties like it's 2000.  Only worries late at night alone, I think.

[Bill1954]

Let me take a stab at a couple of your questions;

It is currently believed that once SVR is achieved, the possibility of transmission is eliminated. If the patient can demonstrate serum HCV RNA negative, it’s thought that “you can’t give what you don’t have”.

However, addressing your next question, you will probably always test positive for HCV antibodies, which will prohibit you from organ or blood donation. I’ve heard anecdotal reports of *infected* TP patients taking HCV antibody positive livers in a pinch, but that info needs to be verified.

Good luck on your upcoming PCR; and of course you investigation into possible cancer.

Best,

Bill

[meNtoby]

I forgot to ask you about Glucosamine Chondoritin Complex, it has worked very well
for me on many joint/bones.  Is it bad for HCV?  And did I read correctly somewhere
that even though one tests positive for HCV that if you are in SVR that you can't spread
the disease?

Just in case I am a spont recoverer, I'd like to know if I can still donate any organ, provided there's no cancer either...and I'm feeling optimistic about that now as well.
I already scratched that on driver's license in case I get hit by a bus or something, didn't
want to pass it on trying to help out someone.

Ahhh, SF, never been there, I'm major landlocked in Midwest.  You know, that's going to be one of the places I go see real soon.  Finally made it to East Coast and that's been
8 years already....dang.  I don't fly anymore though, I drive.  

[meNtoby]

Very good article, and right about he doesn't have the one- he'll find the other.
How he could possibly stay alive with such continued abuse for so many years
is a mystery but now maybe lotta hope for those who choose to change the
behaviors.  I care for him but cannot enable anymore...

You fighters here have given me so much inspiration that I cannot even believe
my entire mindset since I found out just last friday has changed completely.
I never suspected that I might actually have it too, always verrry in shape, healthy,
able to fight off abdominal disease all through 80's.

And anybody feeling sorry for themselves can find help outa that real quick here.
My thinking is things are tough all over.  I think about you guys more than self
right now for sure!  And thanks for that...the waiting is zooming by and I'm staying
busier.

All my best!

[HectorSF]

FYI. Tylenol is not bad for your liver in limited doses. For me with cirrhosis, i was told I could take up to 2000mg per day.

ScienceDaily (Jan. 29, 2008) — Patients with chronic hepatitis C (HCV) infection should not use marijuana (cannabis) daily, according to a study published in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute. Researchers found that HCV patients who used cannabis daily were at significantly higher risk of moderate to severe liver fibrosis, or tissue scarring. Additionally, patients with moderate to heavy alcohol use combined with regular cannabis use experienced an even greater risk of liver fibrosis. The recommendation to avoid cannabis is especially important in patients who are coinfected with HCV/HIV since the progression of fibrosis is already greater in these patients.

"Hepatitis C is a major public health concern and the number of patients developing complications of chronic disease is on the rise," according to Norah Terrault, MD, MPH, from the University of California, San Francisco and lead investigator of the study. "It is essential that we identify risk factors that can be modified to prevent and/or lessen the progression of HCV to fibrosis, cirrhosis and even liver cancer. These complications of chronic HCV infection will significantly contribute to the overall burden of liver disease in the U.S. and will continue to increase in the next decade."

This is the first study that evaluates the relationship between alcohol and cannabis use in patients with HCV and those coinfected with HCV/HIV. It is of great importance to disease management that physicians understand the factors influencing HCV disease severity, especially those that are potentially modifiable. The use and abuse of both alcohol and marijuana together is not an uncommon behavior. Also, individuals who are moderate and heavy users of alcohol may use cannabis as a substitute to reduce their alcohol intake, especially after receiving a diagnosis like HCV, which affects their liver.

Researchers found a significant association between daily versus non-daily cannabis use and moderate to severe fibrosis when reviewing this factor alone. Other factors contributing to increased fibrosis included age at enrollment, lifetime duration of alcohol use, lifetime duration of moderate to heavy alcohol use and necroinflammatory score (stage of fibrosis). In reviewing combined factors, there was a strong (nearly 7-fold higher risk) and independent relationship between daily cannabis use and moderate to severe fibrosis. Gender, race, body mass index, HCV viral load and genotype, HIV coinfection, source of HCV infection, and biopsy length were not significantly associated with moderate to severe fibrosis.

Of the 328 patients screened for the study, 204 patients were included in the analysis. The baseline characteristics of those included in the study were similar to those excluded with the exception of daily cannabis use (13.7 percent of those studied used cannabis daily versus 6.45 percent of those not included). Patients who used cannabis daily had a significantly lower body mass index than non-daily users (25.2 versus 26.4), were more likely to be using medically prescribed cannabis (57.1 percent versus 8.79 percent), and more likely to have HIV coinfection (39.3 percent versus 18.2 percent).

The prevalence of cannabis use amongst adults in the U.S. is estimated to be almost 4 percent. Regular use has increased in certain population subgroups, including those aged 18 to 29.

Hepatitis is an inflammation of the liver. Hepatitis C is the most common form of hepatitis and infects nearly 4 million people in the U.S., with an estimated 150,000 new cases diagnosed each year. While it can be spread through blood transfusions and contaminated needles, for a substantial number of patients, the cause is unknown. This form of viral hepatitis may lead to cirrhosis, or scarring, of the liver. Coinfection of hepatitis C in patients who are HIV positive is common; about one quarter of patients infected with HIV are infected with hepatitis C. The majority of these patients, 50 to 90 percent, were infected through injection drug use. Hepatitis C ranks with alcohol abuse as the most common cause of chronic liver disease and leads to about 1,000 liver transplants yearly in the U.S.

Cheers!
Hector