Thalassemia Patients and Friends
Discussion Forums => Thalassemia-related Issues => Topic started by: Andy Battaglia on August 28, 2006, 03:44:45 AM
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While researching about liver disease, I came across some information that is very disturbing to me.
From http://www.nlm.nih.gov/medlineplus/ency/article/000302.htm
Hepatic coma (Hepatic encephalopathy)...is caused by disorders affecting the liver. These include disorders that reduce liver function (such as cirrhosis or hepatitis) and conditions where blood circulation bypasses the liver...hepatic encephalopathy may be triggered by episodes of gastrointestinal bleeding, excessive intake of dietary protein, electrolyte abnormalities (especially decrease in potassium, which may result from vomiting or treatments such as diuretics or paracentesis), infections, renal disease, and procedures that shunt (bypass) blood past the liver...Complications...increased risk of:
* sepsis
* respiratory failure
* cardiovascular collapse
* kidney failure
From http://www.healthatoz.com/healthatoz/Atoz/ency/liver_encephalopathy.jsp
A normally functioning liver metabolizes and detoxifies substances formed in the body during the digestive process. Impaired liver function allows substances like ammonia (formed when the body digests protein), some fatty acids, phenol, and mercaptans to escape into the bloodstream. From there, they may penetrate the blood-brain barrier, affect the central nervous system (CNS), and lead to hepatic coma.
Lisa Cammilleri, the founder of this group, and my dearest friend, was already suffering from congestive heart failure and kidney failure along with advanced cirrhosis, and was waiting for a liver transplant, when a procedure was done to insert a shunt into her veins.
From http://www.medterms.com/script/main/art.asp?articlekey=17436
Liver shunt: Transjugular, intrahepatic, portosystemic shunt (TIPS), is a shunt (tube) placed between the portal vein which carries blood from the intestines to the liver and the hepatic vein which carries blood from the liver back to the heart.
This procedure was done to prepare Lisa for a liver transplant. After this procedure, Lisa fell into a coma and suffered total kidney and heart failure.
My questions are, did this procedure hasten Lisa's death and was there any alternative to the shunt? Could anything have been done to prepare her body better for this procedure? Or is this the gamble doctors have to take when the liver has deteriorated so badly?
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I think the liver should be left working till the last minute of the transplant!
Why did they by-pass the liver if her transplant was not yet ready? They should do it at the day of the transplant, shouldn't they? :huh
Something tells me this the one of those "fine print" things and we can't really do anything about it if something goes wrong due the doctors "experimenting"!
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Interesting Andy.
I think we need to locate a gastroenteroligist to help us explain this one. I do see somebody for my HepC and I will ask him to come here to answer this question for you and us all.
Miaki