Liver transplant - Let's support each other

Posted by lmctif @lmctif, Oct 29, 2018

What topics do people who are waiting for a liver transplant want to talk about? Who has had a liver transplant and wants to talk about?

Interested in more discussions like this? Go to the Transplants Support Group.

@racing212

I was in hospital in august . my amonia levels went up and i passed out. My meld is 17. I do go to Rochester and its about 3.5 hours away

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@racing212 Cirrhosis really does affect each of us differently. It sounds as if your HE episodes have been fairly severe, yet your MELD is still rather low. The worst HE episodes I had did not bring me close to passing out, although I do remember being almost catatonic with one. With most, I was just very difficult at the worst, and just confused with milder ones -- with those a long nap cured them.

The more I have learned the more I think that diet is definitely an influence on HE, certain foods do create more ammonia. Those are generally protein foods, I think that red meat is probably the worst of those. I kept my meat/fish at dinner down to 4 oz which was different for me because we had generally had larger portions of meat. I was told to not give up protein though so I did continue to have it. Knowing what I know now I think I would keep a food diary of what I eat so when I had an HE episode I could look back and see what may have brought it on.
I have heard of some people giving up meat-based protein entirely but I would not and could not do that myself. My hepatologist (at that time) did not advocate that and I do not believe they do at Mayo either but I am not sure about Mayo.
JK

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@racing212

I was in hospital in august . my amonia levels went up and i passed out. My meld is 17. I do go to Rochester and its about 3.5 hours away

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@racing212, I also live at a distance from Mayo. However, my local docs do coordinate with Mayo, and that gives me confidence that I get the best of care. I hope that that is the way it is with youur docs. I am sorry to hear about your hospitalization. Pre transplant. my hospital and ER visits were quite frequent, and I never got used to them, however I did (unfortunately) become well known to the staff there.
I sincerely hope that you will soon be match for an available organ. It is a matter of time, and speaking from my experience, the waiting can feel intolerable.
I want to emphasize the importance of eating healthy and remaining active prior to transplant. Your body will be better prepared for surgery and recovery will be easier. Are you able to eat and get some exercise?

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@rosemarya

@racing212, I also live at a distance from Mayo. However, my local docs do coordinate with Mayo, and that gives me confidence that I get the best of care. I hope that that is the way it is with youur docs. I am sorry to hear about your hospitalization. Pre transplant. my hospital and ER visits were quite frequent, and I never got used to them, however I did (unfortunately) become well known to the staff there.
I sincerely hope that you will soon be match for an available organ. It is a matter of time, and speaking from my experience, the waiting can feel intolerable.
I want to emphasize the importance of eating healthy and remaining active prior to transplant. Your body will be better prepared for surgery and recovery will be easier. Are you able to eat and get some exercise?

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I'm known to the staff here to.. I still am able work part time i go to a couple stores to walk

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@contentandwell

@racing212 Cirrhosis really does affect each of us differently. It sounds as if your HE episodes have been fairly severe, yet your MELD is still rather low. The worst HE episodes I had did not bring me close to passing out, although I do remember being almost catatonic with one. With most, I was just very difficult at the worst, and just confused with milder ones -- with those a long nap cured them.

The more I have learned the more I think that diet is definitely an influence on HE, certain foods do create more ammonia. Those are generally protein foods, I think that red meat is probably the worst of those. I kept my meat/fish at dinner down to 4 oz which was different for me because we had generally had larger portions of meat. I was told to not give up protein though so I did continue to have it. Knowing what I know now I think I would keep a food diary of what I eat so when I had an HE episode I could look back and see what may have brought it on.
I have heard of some people giving up meat-based protein entirely but I would not and could not do that myself. My hepatologist (at that time) did not advocate that and I do not believe they do at Mayo either but I am not sure about Mayo.
JK

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I've had episode of waking up 3 to 4 days later in a different hospital. That happened 3 times. The Dr's at one. Hospital told a friend that he didn't think i would make it to April. That was last October

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@rosemarya

During my pre-transplant period, while on the waiting list for a liver due to PSC, I was 'temporarily inactivated' when my blood lab results indicated possible cholangiocarcinoma. This required me to be inactivated until a biopsy could be performed and resulted in an "all clear" diagnosis. I would then be re-activated on the transplant waiting list.

@rodney9999, @contentandwell
Here is the definition of Active Candidate from the Organ Procurement and Transplantation Network>Glossary https://optn.transplant.hrsa.gov/resources/glossary/
"A transplant candidate eligible to be considered for organ offers at a given point in time. Some transplant candidates are temporarily classified as “inactive” by their transplant center because they are medically unsuitable for transplantation or need to complete other eligibility requirements."

Rodney9999, this is an excellent question and this is the perfect place to post it. I hope the definition is helpful to you. There is probably no way of knowing what might lead to someone being inactivated, and for how long. But it does happen, and when a person is reactivated, they return to their 'place' as far as ranking by time already spent on the list. This was all new to me when it happened, I guess you can say that I learned by experience.
It is good to hear your voice! How are you getting along?

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Hi Rosemary,

Thank you so much for asking. I am doing well....almost 7 months post transplant without incident. Thanks again for all the useful info you provide on the website...much appreciated.

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@racing212

I've had episode of waking up 3 to 4 days later in a different hospital. That happened 3 times. The Dr's at one. Hospital told a friend that he didn't think i would make it to April. That was last October

Jump to this post

@racing212 when you say last October I presume you are referring to October 2018: not this just past October. If that doctor is not at a hospital that does not do transplants and does not have a hepatology department, he/she is probably not that familiar with your condition.
I live in NH and there are only two hepatologists in the state, both I believe at Dartmouth. There is no hospital in the state that does liver transplants. I was at a Manchester hospital for HE episodes and they really were not that knowledgeable. If I knew then what I know now I would never have gone there but the times that I did my husband just wanted to get me care quickly. One time with a more serious Pre-transplant issue the hospital in Manchester did get an ambulance to bring me to Mass General.
JK

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@contentandwell

@racing212 when you say last October I presume you are referring to October 2018: not this just past October. If that doctor is not at a hospital that does not do transplants and does not have a hepatology department, he/she is probably not that familiar with your condition.
I live in NH and there are only two hepatologists in the state, both I believe at Dartmouth. There is no hospital in the state that does liver transplants. I was at a Manchester hospital for HE episodes and they really were not that knowledgeable. If I knew then what I know now I would never have gone there but the times that I did my husband just wanted to get me care quickly. One time with a more serious Pre-transplant issue the hospital in Manchester did get an ambulance to bring me to Mass General.
JK

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The dr goes to the hospital i was sent to....he's from Rochester mn.i go there to see him. They email him my information if and when i go to hospital

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@racing212

I've had episode of waking up 3 to 4 days later in a different hospital. That happened 3 times. The Dr's at one. Hospital told a friend that he didn't think i would make it to April. That was last October

Jump to this post

@racing212 I also woke up in a different hospital a couple if times. Each had hepatologists but the hospital I ending up going to had the transplant unit/floor. Very disorientating, especially after HE episodes.

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@rosemarya

@racing212, I also live at a distance from Mayo. However, my local docs do coordinate with Mayo, and that gives me confidence that I get the best of care. I hope that that is the way it is with youur docs. I am sorry to hear about your hospitalization. Pre transplant. my hospital and ER visits were quite frequent, and I never got used to them, however I did (unfortunately) become well known to the staff there.
I sincerely hope that you will soon be match for an available organ. It is a matter of time, and speaking from my experience, the waiting can feel intolerable.
I want to emphasize the importance of eating healthy and remaining active prior to transplant. Your body will be better prepared for surgery and recovery will be easier. Are you able to eat and get some exercise?

Jump to this post

@rosemary's such great advice! I was scheduled for PT twice a week at the transplant clinic where they documented everything. The therapists were also transplant clinic nurses and they were very encouraging. I started about 15 months pre-transplant.

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@contentandwell

@racing212 Cirrhosis really does affect each of us differently. It sounds as if your HE episodes have been fairly severe, yet your MELD is still rather low. The worst HE episodes I had did not bring me close to passing out, although I do remember being almost catatonic with one. With most, I was just very difficult at the worst, and just confused with milder ones -- with those a long nap cured them.

The more I have learned the more I think that diet is definitely an influence on HE, certain foods do create more ammonia. Those are generally protein foods, I think that red meat is probably the worst of those. I kept my meat/fish at dinner down to 4 oz which was different for me because we had generally had larger portions of meat. I was told to not give up protein though so I did continue to have it. Knowing what I know now I think I would keep a food diary of what I eat so when I had an HE episode I could look back and see what may have brought it on.
I have heard of some people giving up meat-based protein entirely but I would not and could not do that myself. My hepatologist (at that time) did not advocate that and I do not believe they do at Mayo either but I am not sure about Mayo.
JK

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@contentandwell I just couldn't face eating beef, chicken/turkey or fish prior to transplant and I still had severe HE episodes. Regardless of that I still think your advice is very good. I still have trouble eating meat but make up for it with alternative choices plus Boost or Ensure with extra protein.

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