RE: Living donor vs cadaver/Pam

October 1, 2006

The bile ducts from the donor (living or cadaveric) are not used. A bile

duct is constructed of tissue from your small bowel.

See

http://laxmi.nuc.ucla.edu:8000/NM-Mediabook/figures/GI/liver/UpperDigestive-

U.html (before) and

http://laxmi.nuc.ucla.edu:8000/NM-Mediabook/figures/GI/liver/RouxEnY.html

(after)

The biggest advantage to living donors is you're not on a waiting list, and

it can be done when the patient is in much better shape. The " freshness "

isn't really an issue (or isn't allowed to become an issue).

Arne

55 - UC 1977, PSC 2000

Alive and (mostly) well in Minnesota

________________________________

From: [mailto: ] On

Behalf Of pmfpa1

.... Does anyone have knowledge re the preferable choice. Let's say if

the wait was not an issue. I'm just not sure how reconstructed

ducts would work versus ducts that are placed intact from a

cadaver.

I can imagine that a living donor provides a fresher organ and that,

to my mind means less cell damage...

October 1, 2006

The bile ducts from the donor (living or cadaveric) are not used. A bile

duct is constructed of tissue from your small bowel.

See

http://laxmi.nuc.ucla.edu:8000/NM-Mediabook/figures/GI/liver/UpperDigestive-

U.html (before) and

http://laxmi.nuc.ucla.edu:8000/NM-Mediabook/figures/GI/liver/RouxEnY.html

(after)

The biggest advantage to living donors is you're not on a waiting list, and

it can be done when the patient is in much better shape. The " freshness "

isn't really an issue (or isn't allowed to become an issue).

Arne

55 - UC 1977, PSC 2000

Alive and (mostly) well in Minnesota

________________________________

From: [mailto: ] On

Behalf Of pmfpa1

.... Does anyone have knowledge re the preferable choice. Let's say if

the wait was not an issue. I'm just not sure how reconstructed

ducts would work versus ducts that are placed intact from a

cadaver.

I can imagine that a living donor provides a fresher organ and that,

to my mind means less cell damage...

October 1, 2006

Arne,

This isn't always true. I did get Mike's bile ducts when they

transplanted his liver into me. They attached them to a " limb " of my

bowel (all three of them), but the ducts were definitly his

ducts...My understand of the limb is something like a railroad

siding - they pull up a segment of bowel and attach the ducts to

that segment. That's the only part I'm a little fuzzy on - I have

endoscopic photos of where my bowel branches off into two segments

from when I ahd my varicial bleed in August. They told me that the

one segment continued into the rest of my bowel and the other joined

with my bile ducts.

The reason that there tend to be more complications with living

donors is that the ducts that you recieve are from a section of

liver and are smaller than the common bile duct of the donor. When

the roux en y is done, they make these ducts as short as possible so

as to leave little room for the PSC to reoccur. Getting adequate

blood flow to the donated ducts is difficult and is why I had to

have external stents in my ducts for 6+ months.

HTH,

Deb in VA

PSC 1998, UC 1999, Listed Ltx 2001, LDLTX 5/19/2005

>

> The bile ducts from the donor (living or cadaveric) are not used.

A bile

> duct is constructed of tissue from your small bowel.

>

October 1, 2006

Arne,

This isn't always true. I did get Mike's bile ducts when they

transplanted his liver into me. They attached them to a " limb " of my

bowel (all three of them), but the ducts were definitly his

ducts...My understand of the limb is something like a railroad

siding - they pull up a segment of bowel and attach the ducts to

that segment. That's the only part I'm a little fuzzy on - I have

endoscopic photos of where my bowel branches off into two segments

from when I ahd my varicial bleed in August. They told me that the

one segment continued into the rest of my bowel and the other joined

with my bile ducts.

The reason that there tend to be more complications with living

donors is that the ducts that you recieve are from a section of

liver and are smaller than the common bile duct of the donor. When

the roux en y is done, they make these ducts as short as possible so

as to leave little room for the PSC to reoccur. Getting adequate

blood flow to the donated ducts is difficult and is why I had to

have external stents in my ducts for 6+ months.

HTH,

Deb in VA

PSC 1998, UC 1999, Listed Ltx 2001, LDLTX 5/19/2005

>

> The bile ducts from the donor (living or cadaveric) are not used.

A bile

> duct is constructed of tissue from your small bowel.

>

October 1, 2006

Arne,

This isn't always true. I did get Mike's bile ducts when they

transplanted his liver into me. They attached them to a " limb " of my

bowel (all three of them), but the ducts were definitly his

ducts...My understand of the limb is something like a railroad

siding - they pull up a segment of bowel and attach the ducts to

that segment. That's the only part I'm a little fuzzy on - I have

endoscopic photos of where my bowel branches off into two segments

from when I ahd my varicial bleed in August. They told me that the

one segment continued into the rest of my bowel and the other joined

with my bile ducts.

The reason that there tend to be more complications with living

donors is that the ducts that you recieve are from a section of

liver and are smaller than the common bile duct of the donor. When

the roux en y is done, they make these ducts as short as possible so

as to leave little room for the PSC to reoccur. Getting adequate

blood flow to the donated ducts is difficult and is why I had to

have external stents in my ducts for 6+ months.

HTH,

Deb in VA

PSC 1998, UC 1999, Listed Ltx 2001, LDLTX 5/19/2005

>

> The bile ducts from the donor (living or cadaveric) are not used.

A bile

> duct is constructed of tissue from your small bowel.

>

October 1, 2006

Arne,

This isn't always true. I did get Mike's bile ducts when they

transplanted his liver into me. They attached them to a " limb " of my

bowel (all three of them), but the ducts were definitly his

ducts...My understand of the limb is something like a railroad

siding - they pull up a segment of bowel and attach the ducts to

that segment. That's the only part I'm a little fuzzy on - I have

endoscopic photos of where my bowel branches off into two segments

from when I ahd my varicial bleed in August. They told me that the

one segment continued into the rest of my bowel and the other joined

with my bile ducts.

The reason that there tend to be more complications with living

donors is that the ducts that you recieve are from a section of

liver and are smaller than the common bile duct of the donor. When

the roux en y is done, they make these ducts as short as possible so

as to leave little room for the PSC to reoccur. Getting adequate

blood flow to the donated ducts is difficult and is why I had to

have external stents in my ducts for 6+ months.

HTH,

Deb in VA

PSC 1998, UC 1999, Listed Ltx 2001, LDLTX 5/19/2005

>

> The bile ducts from the donor (living or cadaveric) are not used.

A bile

> duct is constructed of tissue from your small bowel.

>

October 2, 2006

You guys must have ESP.

We just found out this morning at the U of M

Transplant center that I am a good candidate for a

living donor.

That being said, I still don't know if I could let

someone go through that " challenge " for me. The donor

has a harder time than the recipient from what I've

read. I know they have the best of intentions.

Also I found out that I am again an exception to the

rule. I have a constant dull ache on my left side just

under my rib cage and it can get so sharp at times it

brought me to my knees on Saturday. The doc says that

the pain is pretty much hand in hand with PSC

sufferers, but it is on the right side normally.

The Darvocets are getting old. But still necessary at

times. Don't want to spend the rest of my time in a

fog.

Waiting for them to review last CAT scan results and

they will probably be scheduling a fourth. They want

to see if the pain is coming from my spleen or

pancreas. Spleen removal was mentioned. Hope not.

Anybody else have pain on the left side? Increasing in

intensity as disease progresses? Fatigue getting

worse? Just started to feel better after the last

ERCP.

I just received and read " 100 Questions & Answers

About Liver Transplantation " A Lahey Clinic Guide

( & Noble). Very enlightening and actually took

some anxiety about the transplant process away.

Any good recommendations on PSC specific books?

in Minnesota

PSC 2006, Factor V 2002

__________________________________________________

October 2, 2006

You guys must have ESP.

We just found out this morning at the U of M

Transplant center that I am a good candidate for a

living donor.

That being said, I still don't know if I could let

someone go through that " challenge " for me. The donor

has a harder time than the recipient from what I've

read. I know they have the best of intentions.

Also I found out that I am again an exception to the

rule. I have a constant dull ache on my left side just

under my rib cage and it can get so sharp at times it

brought me to my knees on Saturday. The doc says that

the pain is pretty much hand in hand with PSC

sufferers, but it is on the right side normally.

The Darvocets are getting old. But still necessary at

times. Don't want to spend the rest of my time in a

fog.

Waiting for them to review last CAT scan results and

they will probably be scheduling a fourth. They want

to see if the pain is coming from my spleen or

pancreas. Spleen removal was mentioned. Hope not.

Anybody else have pain on the left side? Increasing in

intensity as disease progresses? Fatigue getting

worse? Just started to feel better after the last

ERCP.

I just received and read " 100 Questions & Answers

About Liver Transplantation " A Lahey Clinic Guide

( & Noble). Very enlightening and actually took

some anxiety about the transplant process away.

Any good recommendations on PSC specific books?

in Minnesota

PSC 2006, Factor V 2002

__________________________________________________

October 3, 2006

Marti,

No, I am not going to Lahey, I am only about 40

minutes away from the University of Minnesota and have

been nothing but happy with the care I have received

from the docs and coordinator at the transplant team

which I am still getting to know (2nd eval

appointment), but my hepotologist is the GI chief at

another U hospital.

I am in very good hands and feel very lucky to be so

close geographically. Just makes it so much easier for

the wife and family instead of all the driving and

living elswhere temporarily while recuperating.

I did read the Lahey Clinic Guide " 100 questions and

answers about liver transplantation " . For anyone that

is just getting started down the transplant road I

would highly recommend this book. I have less anxiety

now that I kind of know what to expect.

What is cirrhosis? Who is a cadidite for a liver

transplant? How can I best prepare myself physically

for transplantation? Can I go back to my routine after

transplantation? What does the future hold for liver

transplantation?

From the basics on why, to the process. I love the PSC

group for support and knowledge, but it is kind of

nice to see examples and personal experiences from a

transplant patient both before, during, and after

transplant in a question and answer format.

Best wishes for you and your son Marti!

in Minnesota

PSC 2006, Factor V 2002

__________________________________________________

October 3, 2006

Marti,

No, I am not going to Lahey, I am only about 40

minutes away from the University of Minnesota and have

been nothing but happy with the care I have received

from the docs and coordinator at the transplant team

which I am still getting to know (2nd eval

appointment), but my hepotologist is the GI chief at

another U hospital.

I am in very good hands and feel very lucky to be so

close geographically. Just makes it so much easier for

the wife and family instead of all the driving and

living elswhere temporarily while recuperating.

I did read the Lahey Clinic Guide " 100 questions and

answers about liver transplantation " . For anyone that

is just getting started down the transplant road I

would highly recommend this book. I have less anxiety

now that I kind of know what to expect.

What is cirrhosis? Who is a cadidite for a liver

transplant? How can I best prepare myself physically

for transplantation? Can I go back to my routine after

transplantation? What does the future hold for liver

transplantation?

From the basics on why, to the process. I love the PSC

group for support and knowledge, but it is kind of

nice to see examples and personal experiences from a

transplant patient both before, during, and after

transplant in a question and answer format.

Best wishes for you and your son Marti!

in Minnesota

PSC 2006, Factor V 2002

__________________________________________________

October 3, 2006

Marti,

No, I am not going to Lahey, I am only about 40

minutes away from the University of Minnesota and have

been nothing but happy with the care I have received

from the docs and coordinator at the transplant team

which I am still getting to know (2nd eval

appointment), but my hepotologist is the GI chief at

another U hospital.

I am in very good hands and feel very lucky to be so

close geographically. Just makes it so much easier for

the wife and family instead of all the driving and

living elswhere temporarily while recuperating.

I did read the Lahey Clinic Guide " 100 questions and

answers about liver transplantation " . For anyone that

is just getting started down the transplant road I

would highly recommend this book. I have less anxiety

now that I kind of know what to expect.

What is cirrhosis? Who is a cadidite for a liver

transplant? How can I best prepare myself physically

for transplantation? Can I go back to my routine after

transplantation? What does the future hold for liver

transplantation?

From the basics on why, to the process. I love the PSC

group for support and knowledge, but it is kind of

nice to see examples and personal experiences from a

transplant patient both before, during, and after

transplant in a question and answer format.

Best wishes for you and your son Marti!

in Minnesota

PSC 2006, Factor V 2002

__________________________________________________

October 3, 2006

I don't often post to the group but enjoy reading the various

discussions re PSC and Crohns.

Re: dull ache on left side, I can totally relate to that. It feels as

though I have swallowed a coat hanger at times. I always loved to

exercise but can no longer take on anything too active or the pain

becomes excruciating. The GI reckons it's IBS. I've had an ultrasound

and nothing irregular shows up so I suffer on. Last month, ALP, AST

and ALT all shot up but then new bloodwork results revealed they had

all settled down again. I've had this discomfort for about a year now.

My doctor makes light of it so I don't worry. It's uncomfortable, is all.

Joan

PSC 1997, Crohn's 2002

>

> You guys must have ESP.

>

> We just found out this morning at the U of M

> Transplant center that I am a good candidate for a

> living donor.

>

> That being said, I still don't know if I could let

> someone go through that " challenge " for me. The donor

> has a harder time than the recipient from what I've

> read. I know they have the best of intentions.

>

> Also I found out that I am again an exception to the

> rule. I have a constant dull ache on my left side just

> under my rib cage and it can get so sharp at times it

> brought me to my knees on Saturday. The doc says that

> the pain is pretty much hand in hand with PSC

> sufferers, but it is on the right side normally.

>

> The Darvocets are getting old. But still necessary at

> times. Don't want to spend the rest of my time in a

> fog.

>

> Waiting for them to review last CAT scan results and

> they will probably be scheduling a fourth. They want

> to see if the pain is coming from my spleen or

> pancreas. Spleen removal was mentioned. Hope not.

>

> Anybody else have pain on the left side? Increasing in

> intensity as disease progresses? Fatigue getting

> worse? Just started to feel better after the last

> ERCP.

>

> I just received and read " 100 Questions & Answers

> About Liver Transplantation " A Lahey Clinic Guide

> ( & Noble). Very enlightening and actually took

> some anxiety about the transplant process away.

>

> Any good recommendations on PSC specific books?

>

> in Minnesota

> PSC 2006, Factor V 2002

>

> __________________________________________________

>

October 3, 2006