Hello, Your brother is suffering from liver disease. He is 63 yrs old and has refused transplant. A liver transplant is commonly recommended if a person is suffering from end-stage liver disease (chronic liver failure), cirrhosis, hepatic necrosis, liver cancer, etc. You are suggested to go through all the reports & get repeat liver function tests, blood works, urinalysis, imaging tests like CT, MRI, ultrasound, liver biopsy, etc. done to detect the degree of liver damage. If the liver is not in the end stage, your brother should be put on strict diet control. Boiled food that is easily digested. He should be put on liver tonics and digestive enzymes to help liver repair. He should abstain from alcohol, fatty food, trans fat, oily-junk food, fried food, red meat, refined flour, sugary food, etc. He can take well cooked whole cereals, fruits, veggies, berries, lean meat, small fishes and food that is good for the liver. He should get adequate sleep at least 8 hours a day. He should do regular walking, stay cheerful and adequately hydrated with water and fluids. He should avoid stress both physical and emotional and addictions if any. Strict diet control helps in liver repair, he should get all tests repeated after 35-40 days. The reports should show better results. Diet control should be continued. In case the liver reports do not show signs of improvement then he may have to go for liver transplant. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K., General & Family Physician