A patient suffering from ascites treated with liver transplant

A patient suffering from ascites treated with liver transplant

Patient Review

  • Patient’s Name: Mr. Swamy
  • Patient’s Age: 47
  • Patient’s Gender: male

Symptoms

  • Fluid overload
  • Ascites
  • Infections
  • Coagulopathy

Case Presentation

A 59-year-old male named Mr Swamy, a decompensated cirrhosis patient suffering from ascites, fluid overload, infections, and coagulopathy, consulted Dr Gaurav Gupta for a liver transplant. Mr Swamy was unable to breathe due to fluid overload when he arrived at the OPD. He weighed 120 kgs, and the majority of his excess weight was due to fluid overload. 

Dr. Gaurav Gupta is a skilled liver transplant surgeon in Mumbai. He has performed more than 500 liver transplants in Mumbai. Moreover, Dr Gaurav Gupta is a certified ASTS abdominal organ transplant surgeon.

liver transplant is a complex procedure that necessitates a multidisciplinary and comprehensive approach. End-stage liver disease and cancer patients who want to rehabilitate and restore their health as much as possible can benefit from a liver transplant.

It is critical to remember that cirrhotic liver patients have a reduced level of immunity. Infections plague these people constantly. Furthermore, the presence of the COVID-19 complicates things.

Mrs. Swamy, the patient’s wife, agreed to donate a portion of her liver to him. Mr Swamy had a fever, cough, and trouble breathing during the early investigation and was COVID positive. He was admitted to the hospital for two weeks to recover from the same. On the other hand, his wife and son were also COVID positive, but they recovered well in two weeks.

Mr. Swamy began to experience serious cirrhosis complications, and waiting too long for a transplant would have put him at risk. In such severe conditions, liver transplant surgery is postponed for six to eight weeks. Furthermore, Mr Swamy’s health insurance was set to expire in four weeks, leaving Dr Gupta with no choice except to perform the high-risk liver transplant surgery.

Dr Gupta went over the risks of performing an early liver transplant surgery with the patient, donor, and entire family. Dr Gupta performed the transplant with the approval of the family. Dr Gupta took all necessary precautions before the procedure. Now, he is glad to see the patient doing so well following the transplant.

Treatment and prognosis

  • Liver Transplant

Physical Examination & Tests

  • Pre-operative tests required for liver transplantation
  • RT-PCR test for COVID-19 diagnosis

Feedback

This is what the patient, Mr. Swamy, said, “Dr. Gaurav Gupta and his entire staff were extremely supportive during this tough time for our family. When I was running out of time due to the diagnosis of COVID and the expiry date of my medical insurance, I had given up hope. Dr. Gaurav Gupta and his team gave me hope. After our COVID-19 recovery, they conducted a liver transplant within four weeks. After the transplant, my extra weight was reduced, and now I am 80kgs. My wife and I have entirely recovered. I am speechless when it comes to expressing my gratitude to the entire team.”

Relevant Questions

Q. My wife has issue with abdomen pain & according to Dr the lever is fatty We have done USG of upper & lower abdomen & it shows bit enlargement of lever What shall we do next
 
If on USG liver is fatty, the Patient should undergo some more blood tests to find the cause and degree of fatty liver. We should also check whether this fatty liver is causing hepatitis or not. Treatment will depend upon finding of these tests. I will suggest you to consult a liver specialist and then further treatment can be started.

Q. I have fever and is also experiencing fatigue. i got my blood tests done and the reports showed raised LFTs, but everything else is fine. there is no cough or shortness of breath, is this something to worry about? What is the cause?

Raised LFT can be due to various reasons. Different values in LFT signify different problems. Plus clinical examination will be helpful. You should see a doctor consultation along with a detailed check-up.

Q. What can potentially cause damage liver?

The 3 main causes of liver damage are: Obesity, undiagnosed hepatitis infection and alcohol misuse. There are some other factors that lead to liver damage. That is,
  • Too Much Vitamin A From Supplements
  • Excess intake of Soft Drinks
  • Too much sugar

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Q. My brother is hospitalized in Nair hospital since last 15days because of alcoholic liver infection, not getting improvement .. So i want to consult with you.

If a patient has alcohol-related liver injury generally treatment depends upon the degree of liver injury. some of the patients will recover after alcohol-related liver injury but in case of severe alcoholic hepatitis, liver transplant may be needed. 

If you want to know more, you can refer the article on Alcohol Liver Disease.

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Q. I have had high chronic liver enzymes for the past 10 years, and in this time i visited several doctors, some of them diagnosed my condition to be gilbert syndrome. My bilurbin range is 2 to 5 as both direct and indirect, whereas elevated Alt range is 60 to 100, and my Alp remains within the normal range. Hcv pcr is negative, hbv is also negative, wilson disease is negative, and no hemochromatiis has been detected. I had got my ultrasound done in January this year (2021), everything was normal then and my mrcp was fine too. For the past few months my upper right part of the abdomen has been aching, but that happens only when i walk, otherwise i don’t experience any pain at all. Can i know what is the cause of high alt and bilurbin? Do i have some issue related to liver or is it something else?

Gilbert syndrome does not generally cause high Liver enzymes (AST and ALT), it can cause a rise in bilirubin. Secondly, Gilbert syndrome causes only indirect bilirubin to be high and it doesn’t cause pain in the abdomen. Some of ur symptoms don’t match with Gilbert syndrome. Any rise in liver enzymes needs to be thoroughly evaluated. I will suggest you to consult a liver specialist and get evaluated.

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