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The Liver Transplant Viability Test

August 22, 2014

More Tests

Now it’s time for Leeds to take control. The first stage of this was to give me a thorough testing. A Liver Transplant Viability Test, in fact. Scary-sounding!

The test is a series of tests, designed to assess my liver, and my body’s ability to cope with a transplant. It started with an MRI scan. Unlike previous MRI scans, they gave me a canula so they could inject a dye during the scan. Presumably it’s similar to what they inject during a CT scan, to highlight blood vessels or the biliary tree or something. The scan itself felt a lot longer than normal, and I think I was in there for about an hour. I’m pretty sure I fell asleep again!

Then, a week later, I had the rest of the tests. I don’t have the list with me, so I’ll have to go from memory..

  • Various blood tests (over ten samples taken!)
  • Urine test
  • Chest x-ray
  • Electrocardiogram
  • Heart ultrasound
  • Spirometry test (lung test)

No scary tests there. The weirdest one was the Spirometry, which was basically some breathing apparatus, and a nurse telling me to breath in.. hold.. BLOW OUT! BLOOOW! BLOOOOOOOOW!!! over and over again. Probably the hardest test I’ve had so far!

After the tests, I talked to a few consultants and specialists. I think they were the anaesthetist, a surgeon, a dietician, the liver transplant coordinator, and a bonus visit from one of the consultants. Not all at the same time, mind you – one at a time. 🙂 They all explained why I was having the tests, what they’ve found so far, and what might happen next.

The anaesthetist said that I had a leaky heart valve, but that was nothing to worry about – I should survive a transplant if one was required.

The surgeon went through a few options for what might happen, and asked a few general lifestyle questions.

The dietician said that my liver probably can’t store much glucose anymore, and if I get low then my body will eat muscle. Apparently my tendency to snack on sugary food and drink coke is actually a good thing, and I should keep it up! I need to eat more protein, and she seemed a bit put out that I can’t stand eating nuts (my wife is also apalled – it’s not good for a vegetarian to be a nut hater).

The liver transplant coordinator asked me a few lifestyle questions, and gave an overview of the options. Transplant, remove gall bladder, or monitor.

The liver consultant wasn’t on the list, but popped by anyway. That was good, as he was the most informative! He explained the options, and also the risks and reasoning. He also said that I should stop drinking alcohol completely, unless it’s a very special occasion. 😮

So, what are my options? It seems that there’s debate as to which is most dangerous: remove the gall bladder or replace the liver. A liver transplant is obviously dangerous. I think there’s like a 10% chance of not making it out of surgery alive. Removing the gall bladder doesn’t sound dangerous, but apparently it can have a bit of a domino effect. The removal itself is risky, due to possible bleeding, but it can also cause problems once it’s removed. Without a gall bladder, the liver tries to compensate by increasing bile production. Although the gall bladder isn’t there to inject stones, the increased bile production means there’s more of a chance of the ducts within the liver getting blocked due to PSC. Better to have it block in the bile duct than in the liver, I imagine. The other option is to leave everything where it is, do regular tests, and just make sure the bile keeps flowing.

After the consultants got together and reviewed the tests and imaging, they told me the verdict: leave everything where it is! 🙂

And that was the end of the tests! It’s good that I (and Leeds) know at what stage my disease is, and I can stop worrying a bit. I now have to go to hospital whenever jaundice shows up, rather than when I get feverish, which is sort-of good. I haven’t been jaundiced since the ERCP, and I hope it stays that way. The scars from the aborted gall bladder removal still hurt, which is annoying – I still can’t sleep on my front. Actually, that doesn’t annoy me – it annoys my wife, because it means I’m snoring a lot. 😛

Other than that, I’m healthy, and I’m getting back into cycling. My stamina sucks, but I’m faster than I was last year. I should get back into swimming, too, but my PSC has stopped that in a more unusual way – I lost so much weight that my old swimming trunks are ENORMOUS! I’m only down to a normal weight, btw. I was getting a bit overweight before all this happened, and losing 2 stone was by no means a bad thing.

The only thing left on the horizon is a possible ERCP to remove my biliary stent, but it seems that I might not actually have one. The report from Manchester Royal Infirmary seemed to indicate that they hadn’t put one in, but all the reports from the surgeon at Stepping Hill indicated that I had one in place. Leeds aren’t sure, so they’re contacting the person who put it in. If I don’t have one, then I’m free! well.. until the clocks change.. will I go yellow at the strike of 12? I shall try and keep this updated!

Adios!

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