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Alcohol Abuse And Diagnosed With ALD, Liver Cirrhosis And Portal Hypertension, Under Treatment. Survival Rate?

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Posted on Tue, 15 Oct 2013
Question: My uncle is alcohol abuse and diagnosed with ALD - Decompensated cirrhosis of lier with portal hypertension , grade II esophageal varcies child pug class C, S. BP

Procedure - Gastroscopy + Ascites Tapping

He is under treatment at Apollo Hospital, Ahmedabad, please let me know his chances of survival and other treatment option to save him.
doctor
Answered by Dr. Dr.P.Ratnakar Kini (3 hours later)
Brief Answer:
Detailed answer given below

Detailed Answer:
Hi XXXXXXX
Thanks for posting your query.
I am Dr.Ratnakar Kini and I am pleased to assist you.

You have said that he comes under Child Pugh Class C.
The 2 year survival for class C is about 30-40%

For decompensated chronic liver disease, the only definitive treatment is liver transplantation.
Other measures for only to prevent complications like gastrointestinal bleeding, spontaneous bacterial peritonitis ( infection of the fluid accumulated in the abdomen), hepatic encephalopathy ( involvement of the brain).
He needs to continue taking Ciplar LA and Fruselac. Ciplar LA controls the portal pressure and prevents bleeding from the gastrointestinal tract and Fruselac is the water pill which reduce the fluid in the abdomen and legs.
If he is constipated, he needs to take Duphalac.

All these medications are there in the prescription given by his doctor.
Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr.P.Ratnakar Kini (16 minutes later)
Thanks Doctor for your kind advice,

It means only he 30-40% people survive up to 2 years in this stage liver cirrhosis !

As liver transplantation is very expensive treatment, we will discus in family about this, please let us know what would be cost of liver transplant in India ?

doctor
Answered by Dr. Dr.P.Ratnakar Kini (18 minutes later)
Brief Answer:
Detailed answer given below.

Detailed Answer:
Hi,
Yes, only 30-40% with Child Pugh C survive up to 2 years.

Liver transplant is a very costly treatment. It may cost anywhere between 40 and 50 lakhs.

Moreover donor liver is not readily available.
Patients who need liver transplant are included in the organ transplant registry.
Those high up in the list get transplanted first when the organ becomes available.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr.P.Ratnakar Kini (4 hours later)
Thanks for advice and information Sir,

One more thing I just need to know what would you suggest , either we go ahead for liver transplantation process or just continue the treatment providing by current Doctors and wait for some time.

Please suggest on basis of current medical reports provided that what should we do.

Thanks
doctor
Answered by Dr. Dr.P.Ratnakar Kini (18 hours later)
Brief Answer:
Detailed answer given below

Detailed Answer:
Hi XXXXXXX
As mentioned in my previous post, liver transplantation is the only definitive treatment for decompensated liver disease.

But as told earlier, many factors are involved - the huge cost, the availability of the donor organ etc.
So you need to take the final call after discussing with your family members whether to get his name registered for liver transplantation.

But your uncle needs to continue with the advice of his doctors, take the medications and go for regular followup treatment as advised.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
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Dr. Dr.P.Ratnakar Kini

Gastroenterologist

Practicing since :1994

Answered : 2208 Questions

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Alcohol Abuse And Diagnosed With ALD, Liver Cirrhosis And Portal Hypertension, Under Treatment. Survival Rate?

Brief Answer:
Detailed answer given below

Detailed Answer:
Hi XXXXXXX
Thanks for posting your query.
I am Dr.Ratnakar Kini and I am pleased to assist you.

You have said that he comes under Child Pugh Class C.
The 2 year survival for class C is about 30-40%

For decompensated chronic liver disease, the only definitive treatment is liver transplantation.
Other measures for only to prevent complications like gastrointestinal bleeding, spontaneous bacterial peritonitis ( infection of the fluid accumulated in the abdomen), hepatic encephalopathy ( involvement of the brain).
He needs to continue taking Ciplar LA and Fruselac. Ciplar LA controls the portal pressure and prevents bleeding from the gastrointestinal tract and Fruselac is the water pill which reduce the fluid in the abdomen and legs.
If he is constipated, he needs to take Duphalac.

All these medications are there in the prescription given by his doctor.
Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini