getting sicker, what could they be waiting for?

[debben55]

Dear Doctor,
I am 55 and have end stage non alcoholic cirrhosis with hep c and with hepatic encephalopathy and every few months they are banding my esophagus. I also have virtually no platelets so they have to give me two bags of platelets prior to the banding. I have recently been diagnosed with RA Factor. I have dozens upon dozens of broken spider veins all over my face, hands and chest. They are constantly checking my tumor count and so far no tumors. My question is since  I'm decompesated ( excuse the spelling)  what else could they be waiting for in order to get my transplant? I have been on the transplant list for over two years all along with these factors. My strength is non existent and I have blacked out several times. I can not taste food, eat very little but have the usual very large stomach.

[Thomas D Schiano, MD]

they should consider trying to treat your HCV with the new medications if they can do it safely--maybe that could prevent you from needing a transplant

[Thomas D Schiano, MD]

good luck

[debben55]

Thank You. You have been very helpful. I appreciate you taking the time to answer my questions.

[Thomas D Schiano, MD]

there are new HCV medications that are very well tolerated and dont require the use of interferon and maybe not even ribavirin.  Although the risk for developing HCC will persist for some time, there is some hope that eradication of the HCV could stabilize your clinical disease and obviate the transplant.  If your MELD is low and your doctors feel strongly that a transplabnt is necessary ASAP, then a live donor transplant may need to be an option.

[debben55]

I did treat with interferon for a year and it was a horrible failure. They said it made all my blood test values shoot off the chart. You're saying I could live fine with end stage cirrhosis. Why would they place me on the transplant list if this is the case. My primary and gastroenterologist always say they thought I would have passed away the previous year. This has been going on for a lot of years. But the last two is when I became decompesated with hepatic encephalopathy and bleeding esophagus,which they band every so many months. I'm confused now that you have said I could live  just fine in my present condition.