Compensated liver disease versus decompensated

[Guest guest]

Hi, everybody. I want to clarify for some newcomers the difference between

compensated liver disease and decomopensated. When a person is diagnosed with

cirrhosis, the diagnosis itself is no indicater of the total picture. It would

be no different than if the doctor told you that you had cancer. Cancer? What

kind of cancer? What stage of cancer... you get the picture, a quick google

search can find for you the least bad and the worst bad kind of cancer to be

told that you have. It is not as quite so simple with liver disease, but we can

make it so with some simple explanations and tools. The tools are MELD score and

Child Turcotte Pugh score. Both of these simple scores can give you and your

doctor a very quick glimpse of how sick you are. Jackie posted today that her

dear husband is in the hospital and has a MELD score of 26... well 26 is getting

up there. I truly believe that he will be getting a liver pretty quick now. All

of his other ducks are in a

row, and they have been to HELL and back to please the surgical team for this

surgery.

The Childs score goes by a combination of complications and blood test and not

by blood test alone, so it is more subjective. The score increases for ascites,

and hepatic encephalopathy.

http://en.wikipedia.org/wiki/Child-Pugh_score

http://www.mayoclinic.org/meld/mayomodel6.html

Decompensated liver disease is when the person develops a major complication.

These include ascites or bleeding varicies or hepatic encephalopathy or

hepatorenal syndrome, or hepatopulmonary syndrome. At this point, it is prudent

to get a referral for a liver transplant.

In the case of alcoholic cirrhosis, a 6 month to two year period of sobriety is

required not only to prove to the team that you are serious about quitting

drinking

but also to either improve or get worse. Most patients improve, but some get

worse and require a transplant soon. Some never make it to the point of

transplant, and die.

In the case of compensated liver disease, a person can live a very long time if

the original cause of the disease is stopped, either by lifestyle changes or by

treatment in the case of Hep C.

So, when we say that a person can live a long long time with liver disease, this

is a true statement, but once signs of liver failure begin to show

up,(complications) it is usually only a matter of time before the person is very

very sick and must either seek a transplant or hospice care for end of life.

These seem to be the only two really reasonable choices.

Cirrhosis is the end stage of all liver diseases, so it is oten called end stage

liver disease at most transplant centers.

End stage liver disease is not always by itself a death sentence... in fact for

most people with ESLD, they die from some other complication or infection and

not the end stage liver disease itself. It is no picnic, but it need not stop a

person from going on with their lives. My opinion is that a person can extend

thier time by abstaining from alcohol, and eating as healthy a diet as possible

and keeping a positive attitude.

Just remember- compensated versus decompensated... there is a big difference.

Love, Bobby