February 27th, 2007 08:45 PM #1Junior Member
- Join Date
- Feb 2007
cirrhosis of the liver
My brother, who is only 52 had contracted Hep. C when he was in Vietnam. The disease became active around 8-10 years ago. In 2005 he received a liver transplant and was successful, meaning there was no rejection, however the new liver came with a virus, and the Hep. C came back with a vengance. He was in the Hospital this past weekend, suffering from being extremely jaundice. His stomach is huge and he is suffering from amonia build up which causes him to hallucinate. His blood counts were very low, so they gave him 2 pints of blood to raise his counts which helped, and then sent him home. I don't know what kind of time he has left. I would like to know what to expect in these final stages of cirrhosis. Thanks, SS
February 28th, 2007 03:50 AM #2Unregistered Guest
Re: cirrhosis of the liver
Abnormal biochemical function of the liver in cirrhosis can lead to several complications. The serum albumin concentration falls which can lead to aggravation of ascites and edema. The metabolism of drugs can change requiring dose adjustments. In men, breast enlargement (gynecomastia) sometimes occurs because metabolism of estrogen in the liver is decreased. Decreased production of blood clotting factors can lead to bleeding complications. Derangements in the metabolism of triglycerides, cholesterol and sugar can occur. In earlier stages, cirrhosis frequently can cause insulin resistance and diabetes mellitus. In later stages or in severe liver failure, blood glucose may be low because it cannot be synthesized from fats or proteins.
Cirrhosis, especially in advanced cases, can cause profound abnormalities in the brain. In cirrhosis, some blood leaving the gut bypasses the liver as blood flow through the liver is decreased. Metabolism of components absorbed in the gut can also be decreased as liver cell function deteriorates. Both of these derangements can lead to hepatic encephalopathy as toxic metabolites, normally removed from the blood by the liver, can reach the brain. In its early stages, subtle mental changes such as poor concentration or the inability to construct simple objects occurs. In severe cases, hepatic encephalopathy can lead to stupor, coma, brain swelling and death.
Cirrhosis of the liver can also cause abnormalities in other organ systems. Cirrhosis can lead to immune system dysfunction causing an increased risk of infection. Ascites fluid in the abdomen often becomes infected with bacteria normally present in the gut (spontaneous bacterial peritonitis). Cirrhosis can also lead to kidney dysfunction and failure. In end-stage cirrhosis, a type of kidney dysfunction called hepatorenal syndrome can occur. Hepatorenal syndrome is almost always fatal unless liver transplantation is performed.
February 28th, 2007 03:58 AM #3Unregistered Guest
Re: cirrhosis of the liver
The patient becomes drowsy, nauseated and thirsty. Terminally, the patient's blood pressure drops, coma deepens and urine volume falls further. The terminal stages may last a few days to weeks.
TABLE 22. Diagnosis of hepatorenal syndrome from liver failure