RE: I Really Need Help With This One?

October 13, 2005

You know...I was just reading that part over and thinking....NO WAY!

It couldn't have been a live donor.....because they remove one THIRD of

the liver if it's a live donor....and on someone who has been ill for a

long time, many times a third of a liver is deemed to be

insufficient....they feel that a whole liver will give you the best

chance. So a third of an infected liver? No way....

Silvia

>

> yes all well and good but tell me how a person with HCV can be a

> live donor? I assume this person wants to donate Half his liver?

> Does this person want to hasten their own death? What stage

> damage is the donor liver? what even slight chance would the

> donor have to survive? Did I read it right? ric

>

October 13, 2005

Live donors give one third of their liver.....it takes just a few

weeks for it to growe back....BUT.....it doesn't always grow

back....and many hospitals have stopped doing live donor transplant

because of the high rate of donor mortality.

Silvia

>

> >

> > yes all well and good but tell me how a person with

> > HCV can be a

> > live donor? I assume this person wants to donate

> > Half his liver?

> > Does this person want to hasten their own death?

> > What stage

> > damage is the donor liver? what even slight chance

> > would the

> > donor have to survive? Did I read it right? ric

> >

>

> __________________________________

> Music Unlimited

> Access over 1 million songs. Try it free.

> http://music./unlimited/

>

October 13, 2005

I really doubt it wasd a live donor. Come on, bet me.

Silvia

>

> yes I know that and I hope doctors have common sense. But

> I am talking about a person who has HCV donating half his liver.

> Will that liver regenerate at the same rate or at all? Call me

> stupid if you want but thats what 's e-mail said.

>

October 13, 2005

That's true....some people have a combination of genotypes. Genotype

1B is the one that infects new transplanted livers quicker. I think

more important than genotype is tissue match, same blood type, age of

donor and SEX. If thge donor is female and the recepient male, because

of hormones, transplanted organs don't do well.

Silvia

>

> and here's another question. are you sure that the same genotype

> is 1 of the requirements of an HCV donatable liver. I asked my

> Dr. Everson about cross contamination of genotypes. I wanted to

> know if it's possible to have more than 1 geno? He said yes and

> he didn't think based on current knowledge that it would mean

> much as it relates to the to the patient.

>

October 13, 2005

....did you really mean that the liver was coming from someone

that was alive?

Silvia

>

> Thanks You for all your responses,

> It definitely adds to my questions next Dr. visit,

> it really makes me look differently at this....

> I never expected a call like that,

> I thought the only decision I would have to make is " We Have A

Healthy Liver

> That Matches You, Do You Want It " .......

> WOW!!!!!!!!!!!! Was I wrong

>

> Thanks Again

>

October 13, 2005

right on Sylvia. mis-communication all the way. that would be a

crime and kill 2 people.. I'm thinking of the movie, what was

it?? Denzell was going to kill himself so his son could have a

heart? I thought well maybe it was something like that. and

they were notifing the next in line just in case?? Not trying to

make light, but it just sounded stupid. For me to accept a live

donor, I would have to know that person very well, cause like

you say, your only getting a third of it.

October 13, 2005

But in a few cases they took up to 60% of the liver from the donor.

You see, it's really all about size.....LOL

Oh I just couldn't resist

Silvia

>

> right on Sylvia. mis-communication all the way. that would be a

> crime and kill 2 people.. I'm thinking of the movie, what was

> it?? Denzell was going to kill himself so his son could have a

> heart? I thought well maybe it was something like that. and

> they were notifing the next in line just in case?? Not trying to

> make light, but it just sounded stupid. For me to accept a live

> donor, I would have to know that person very well, cause like

> you say, your only getting a third of it.

>

October 13, 2005

They try to match genotypes but in some cases where people were going

to die they mixed. Genotype 1B is the one that is known to infect

new livers quicker. Sometimes it does so with a vengence and the new

livcer is cirrhotic in about 2 or 3 years. That is why they are not

treating pre-transplant. If they can lower the viral load by the

time of transplant, organs do better. In some cases, treating before

transplant for 12 weeks has resulted in SVR...only about 20% which is

the same success rate we get if we treat AFTER a transplant...but at

least you treat for 12 weeks only instead of the whole year (or

longer). To be honest, I can't imagine treating before transplant

when people are already so sick but it's being done. Treating right

before or after transplant is still considered investigational and

very dangerous. Al.ot more things can go wrong.

I have two forum members who had transplants and 3 years later they

both had cirrhosis. The female didn't do well on treatment. Her

worst problem was anemia. Because she has Medicaid, it won't pay for

a second transplant. She is now end stage.

The male, who's also diabetic, treated with Pegasys 180mg/Copegus

1200mg and after 6 months he was still not clear. They planned to

continue because there were no more options, his citrrhosis is

advanced. Then he had a stroke (no deficits from it)and the

treatment was stopped. His viral load went back up ionto the

millions. When he recovered from the stroke he decided to try

again. This time, and against my advice, they were putting him on

Pegasys again and only 800 mg of Copegus. The second time, he

cleared at 12 weeks and he just got his 24 week viral load and

remains clear.

What do you think was the difference? We somehow had to make it

better.

We got rid of the insulin resistance and beat the odds. His blood

sugar had been out of control the first time.

Silvia

>

> My understanding is that the shortage of transplantable livers, and

the high

> need for them for HCV patients has resulted in beginning to use

livers from

> infected donors to implant into other infected patients. On some

levels this

> makes sense. It provides some hope where none existed before. The

questions

> I've seen raised on this subject were the genotypes of the two, is

the donor

> geno a different type than yours? That would result in a dual, or

more, geno

> infection. What is the condition of the liver. Hopefully they

aren't trying

> to implant cirrhotic livers. Many with HCV have minimal liver

damage.

> Implantation into an infected person will result in an infected

liver, even

> if it weren't before. And something I'm not clear on, is HCV

treatment a

> reasonable thing after transplant. I understand that its done for

some. I'm

> not clear on the interaction between the IFN, the anti-rejection

meds, and

> the rejection situation itself. I admit I haven't read the reports

on that.

>

> Sally

>

> I Really Need Help With This One?

>

> I need to know something,

> I am at the top of the transplant list and just received a call

from s

> Hopkins... That there was a live donor and that the liver was

infected with

> HEP-C, they wanted to know if I wanted it.. I am sick and really

want to get

> this over with BUT why would they transplant a liver already

infected?

> Should I have taken the liver? This really has me worried, it

caught me way

> off guard. Now I am second guessing my decision to turn it down

>

> Thanks for any help

>

October 13, 2005

It really is ok Rog. the next one will be here before you know

it. This just gives you the chance to finish packing your bag to

take with you. A trial run is a good thing. I hope they just

tell you they have a liver for you and to get here NOW! How far

away is the transplant center?

October 13, 2005

I just talked to the doctor,

He said I have Active HEP-C,

No matter what liver I get, it with Get\Have Hep-C,

Wether it's Hep-C clean or not,

What they do is transplant ONLY the clean tissue,

I have cirrhosis now, the new one will not have cirrhosis, or they will cut