Suggest Treatment For Decompensated Liver Cirrhosis

Brief Answer:
Following suggestions....

Detailed Answer:
Hi XXXX,

I am sorry about the health situation of your uncle.

1. He is suffering of decompensated liver cirrhosis of MELD 16 stage. MELD is a system score that would determine the life expectancy in patients with liver cirrhosis. In your uncle's case, he has 15% of mortality in the next 3 months.

2. Being an alcoholic has damaged his liver at decompensation stage. At this point, he is a probable candidate for liver transplant.

3. As the list for transplant is long, he should be treated as following according to his actual clinical symptoms:
- if esophageal hemorrhoids will appear, propanolol is recommended together with local treatment like : ligature or TIPS (transjugular intrahepatic portosystemic shunt)
- if ascitis (abdominal edema) is present, then, diuretics (e.g. spironolactone) are recommended together with albumin
- antioxidants like vit.E, silymarin, etc.
- stomach protectors like PPIs or antacids
- lactulose to prevent encephalopathy

4. These are general information. In order to assist your uncle specifically, I need to know:
- his current liver function test result
- the results of other biochemistry testing
- abdominal ultrasound or other endoscopic testing he has done so far
- history of bleeding: upper/lower GI bleeding?
- history of peritonitis?
- symptoms for hepato-renal syndrome?

Hope it was of help!
Dr.Klerida

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Brief Answer:
Please follow the suggestions below,,,,

Detailed Answer:


Hi back,

Liver transplant costs are variable from country to country (from clinic to clinic) even for the same procedure.

I only can give you an average cost of today medical practice. Exact cost should be asked to the treating doctor.

The average cost of liver transplant vary from 150 thousands $ to 300 thousands $ in the States and from 35 thousands to 50 thousands $ in XXXXXXX

The chances of survival without transplant are poor only 10-20 % may survive after 5 years.

Wish you and your family health!
Dr.klerida

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Brief Answer:
Following advice.

Detailed Answer:
Hi back,

Meld score is a specific score that serve to evaluate the mortality and survival rates for the future three months. The Child-Pugh classification is the best score to calculate the survival rates for 5 years.

I would like to have more of his medical data (other than Meld score data) to give a more accurate opinion. With these data i would be able to calculate the avarage survival rate in five years.

In case that he can't afford the liver transplant, there are some treatment options to prolong the survival rates of these patients.

If he was my patient I would recommend to do the following examinations to prolong his survival rates :
- Ligation of esophageal varices
- TIPS procedure

Wish you and your family health!
Dr. Klerida

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