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MELD Score of 12 with complications

Can you please tell me in your opinion how long someone may have to live with a Meld score of 12 and compications with encephalopathy, ascites. I just got out of hospital two weeks ago due to encephalopathy. MY ammonia level was 90 with his lactulose at 5 tablespoons 3 times a day. now they lowered it and I have to try to adjust it so I have 3 to 4 bowel movements a day. Also I am confused about protein, one Dr. tells me to limit protein to 3 oz or less per meal, the liver Dr said I need protein and not to worry about it unless I eat a real large steak or alot of sauges etc. I am on a water restriction of no more than 8 eight oz of water per day with a 2,000 mg of salt restriction also. Just am confused about this protein issue also.
Thank you
David
3 Responses
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517301 tn?1229797785
MEDICAL PROFESSIONAL
what I am saying is that almost always patients with your MELD do extremely well for long periods of time and that actually transplantation may not be indicated for them.  at our center, we actually do not list patients for a transplant unl;ess their MELD scores are 15 or greater. the best philosophy is to wait as long as possible for the transplant because it is trading 1 set of problems for another.
Helpful - 1
Avatar universal
Thank you for answering my questions above. So you are saying if I have a liver transplant I will have less than a year considering I am age 62 and have other health problems like COPD. I am not sure they can do a transplant due to other health issues they are checking into that now as far as I know.
The reason I am on a sodium diet and a water restriction is my kidneys I am told are not functioning the way they should and I have fluid back up in legs and stomach that they worked on in the hospital and managed to get it a little better but it keeps comming back. Also I was admitted as my blood was comming to the top of my leg as I was told the blood was not clotting the way it should.I have been told 80% of my liver is damaged and all that remains good are two little lobes. That is why I was wondering how much time I would have to live like this if I cannot have a transplant?
Thank You
David
Helpful - 1
517301 tn?1229797785
MEDICAL PROFESSIONAL
typically patients with a MELD score of below have a better 1 year survival without liver transplantation as compared to with it.  brittle encephalopathy can be a problem.  maybe your doctor can start xifaxan in addition to the lactulose. we really don't limit protein intake as it just accelerates muscle wasting and malnutrition.  you should be taking at least 1 gm protein/kg body weight and maybe a bit more. sodium restriction is often necessary but fluid restriction is only important if the pt has a low sodium level.
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