Hello my friends! I am writing this next article (finally, I know) on needing a transplant because it is a question I get often, usually after I have scared someone with liver disease by telling my story. (whoa Nelly, hold your horses, I was sick for many years before being transferred to USC to discuss a transplant, and everyone is different). Once diagnosed with liver disease, a lot of people jump straight to the thought of needing a transplant, but remember that a transplant should be your “last resort”. No matter where you are in your disease, there is something that you can do (see my previous article on Do’s and Don’ts for your liver here on the FLAGC site, and even more details on The Antics of Larry the Liver – Yes, I’m plugging one of my own blogs. teheheee)
Like I have said before… The liver is so resilient!! However, there is nothing that can replace its function, even temporarily. In other words, no dialysis like there is for kidney failure… etc. Once your liver has become decompensated (unstable), you will most likely be hospitalized for one or more of the following symptoms on more than one occasion: Ascites, Spontaneous bacterial Peritonitis, Hepatic encephalolpathy, and/or Esophageal Varices. However, in my “non-expert” opinion, the prescribed medicine in itself should be considered a second-to-last resort. You should first try to control symptoms with diet and exercise (Again, check out The Do’s and Don’ts for Your Liver article.) Only once you have exhausted all other options, and your liver is still unstable is when a transplant should be given. This is not an easy way out and requires a lot of work for the rest of your life.
Here in the U.S. a MELD score (or PELD for Children – Pediatric) will calculate where you are on the transplant list. (How sick you feel is not part of this calculation. Bummer!) UNOS uses 3 lab results that determine your MELD score for patients 12 and older (The MELD and PELD scores are based on a patient’s risk of dying while waiting for a liver transplant, and are based on objective and verifiable medical data.) Your INR, your Creatine level, and your bilirubin. Your INR calculates how fast your blood clots (and believe me, you will know if this abnormal because you will ruin many towels on bleeds you thought were small – Please CALL 911, they have meds that will clot your blood for you.) Your Creatine calculates your kidney function, which is usually impaired with severe liver disease. Your Bilirubin calculates how effectively the liver excretes bile – which gave me the nickname “Itchy Ricki” for a long time, and “Banana Mama” for even longer – Bilirubin is what gives cirrhotic patients the yellow color. But don’t forget, there is still light at the end of the tunnel – a new liver, a new life!
Transplants are occurring more and more, and are more successful then ever. You may wait months, or you may wait years for your score to reach the number you need for your transplant. Certain states have the opportunity to transplant you at a lower number, but here in California, most have to wait until they reach a score of 30 or above. This is mainly because of the shortage of organs. That is right, all these people are suffering (many dying) because others have not become organ donors and have not discussed their wishes with their family.
I myself was blessed twice! First, just over a year ago, with a living donor, and again, only one month ago with a deceased donor – one courageous cousin-in-law willing to sacrifice a piece of their own liver while still alive, and one courageous family, willing to give the gift of life to others during their time of such grief. My heroes! So please, don’t forget to sign up to become an organ and tissue donor, and discuss it with your family because they can over-rule your wishes if they want. Go to Donate Life America to sign up and/or learn the facts on organ donation.
This article is intended to convey general educational information and should not be relied upon as a substitute for professional healthcare advice.