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?

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?

Answer: 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.

What can potentially cause damage liver?

What can potentially cause damage liver?

Anwser : 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

All About Organ Donation

It is estimated that nearly half a million Indians suffer from end-stage organ failure every year. However, less than 5000 kidney transplants are performed per year, despite demand of over 200,000.

Similarly, only 1500 liver transplants are performed in India per year. However, over 100,000 people die from end-stage liver disease in India. Most of these liver diseases are caused by preventable conditions such as hepatitis B and C.

The annual requirement for hearts is estimated to be about 50,000, and for lungs, it is estimated to be about 20,000. While most organ transplants are conducted after brain death, most of the programs depend on living donors.

Majority  of the transplants ( Liver and Kidney) happening in India are Living Donors. It exposes poor population to the risk of bribery and other malicious attempts.

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So, the need for organ donation after brain death (BD) has become very important. The rate of organ donation has risen tenfold in the last five years, reaching 0.86 per million people.

More and more families are going forward to donate their loved one’s organs. After BD, over 900 people donated over 2800 organs in 2017. Everyone should commit to donating their organs and contribute to the saving of lives.

When most people consider pledging for organ donation, some questions arise in their minds. Here are ten things that one must know about organ donation:

Organ Donation is legal in India

The Transplantation of Human Organs Act 1994 of India first provided regulations for the removal, storage, and transplantation of human organs for treatment purposes. The Act was amended in 2011 and put into effect by the release of Rules in 2014, which included numerous amendments to declaring brain death and organ retrieval.

All adults can pledge to donate organs 

Someone over the age of 18 can make an organ donation pledge. Organ and tissue donation has no age restrictions. The transplant teams assess the suitability of each organ and tissue at the time of brain death.

Brain death is death

In patients with brain death, the brain dies due to stroke, head injury, or brain tumor, but the heart continues to beat for a few hours or days. So, the essential blood flow to the organs is preserved. The effects of brain death are permanent. When a person is announced brain dead, the death form is filled out even if the heart is still beating. It is a legal for of death.

Treatment quality is unaffected by organ donation

Only after the patient is brain dead, the doctors discuss organ donation with the patient’s family. The treating teams have a mandate to make every attempt to save lives and have no role to play in organ donation.

Number of organs and tissues that can be donated

By donating the heart, lungs, liver, kidneys, pancreas, and small bowel, a single non-living beating-heart donor will save eight lives. Several tissues, such as the cornea, heart valves, eardrums, ear bones, tendons, and skin, can also be donated after the heart stops beating.

Brain death is not difficult or costly to diagnose

Bedside tests conducted by a team of four doctors and repeated after 6 hours are used to diagnose brain death in India. There are no costly tests needed.

The cost of maintaining the cadaver, retrieval of organs or tissues, transportation, and preservation, is not borne by the donor family. These costs are borne by the recipient, institution, government, or non-governmental organization as decided by the respective State Government.

No pain or mutilation

A brain-dead person is dead and does not feel pain. Organs are removed in the operating room with the utmost care and dignity by a team of specially qualified surgeons

No legal standing for the donor card

A person can make organ donation pledges through government, non-governmental, and private organizations. The pledge is not limited to a single nation, state, or hospital. The donor is on a ventilator at the time of brain death, and the hospital staff asks the family about organ donation. Although pledging is not required for organ donation, it does assist the family in making the best decision possible. As a result, it is important that one tells their family about the decision to become an organ donor before they sign up.

Organs are given to those who need them the most

The National Organ and Tissue Transplant Organization (NOTTO) manages organ donation. The organization is built on a straightforward framework that guarantees that the sickest patients get transplants first.

India is poised to enter a new era of deceased organ donation with experience, infrastructure, funding, and increased knowledge. Finally, it comes down to trusting the doctor and the medical system and honesty in the organ allocation process.

Liver Treatment – Symptoms and Diagnosis

The human liver is situated on the right side of the abdomen. It is one of the most significant and essential organs in the body under the rib cage. It is one of the vital and crucial organs for survival. The liver performs many functions in the body. By some estimates, it does more than 800 functions in the body.

It produces the necessary biochemicals responsible for digesting food and driving toxic substances out of the body. However, several diseases can occur to a liver if it’s not taken care of properly. A few of these are genetic, but other than inherited liver problems, the rest are caused by various factors.

Viruses, infections, alcoholism, and obesity can all cause damage to the liver, as well as scarring and cirrhosis. Cirrhosis and long-term damage to the liver can result in liver failure, which is a life-threatening condition. It can be avoided by seeking early treatment from a liver specialist in Mumbai, which aids in the healing of the liver.

Vital Functions of the Liver

1. Helps in food digestion

2. Maintain blood sugar level

3. Produces blood clotting factors

4. Breaks down many drugs and poisons

5. Help body resist infections by making proteins and immune factors

What can damage the Liver?

Liver damage can occur suddenly (acute) or can happen over a prolonged period (chronic). Most of the patients have a chronic form of liver disease.

1. Acute Liver Failure

  • Severe Viral Infections (Hepatitis A or B)
  • Rat Poisoning (Yellow Phosphorus)
  • Excessive ingestion of Paracetamol, some herbal drugs, or Chinese medication

2. Chronic Liver Failure

  • Excessive alcohol intake
  • Viral infections like Hepatitis B and C
  • NASH (fatty liver due to obesity, long term diabetes, high cholesterol, hypertension)
  • Various autoimmune disease

3. Pediatric Population

Symptoms of liver disease

In Early Stage

  • Jaundice (yellow discoloration of eyes and skin)
  • Dark-colored urine
  • Black colored stools
  • Itching
  • Weight loss, loss of appetite, weakness
  • Easy bruising and bleeding tendency

In Advanced Stage

  • Swelling of limbs (edema)
  • Water accumulation in the abdomen (ascites)
  • Blood in vomitus
  • Mental confusion and forgetfulness (Encephalopathy)
  • Change in sleeping habits
  • Frequent infections
  • Kidney and other organ failures

Diagnosis of Liver disease

  • Liver Function Test
  • Viral serology (Hepatitis B, C, HIV)
  • Liver Elastography
  • Liver Imaging (Ultrasound Doppler, Triple phase CT scan, MRI liver)

Treatment for Liver Disease

Liver treatment is particular to the diagnosis and condition. While some liver problems are treated with medications, some liver problems are treated with lifestyle changes. These changes may include zero alcohol consumption, weight loss, or a change in the diet. During this period, the liver specialist may closely monitor the patient’s liver function. Liver problems such as liver failure may require surgery or a liver transplant.

Lifestyle changes help to improve liver health. Once diagnosed, the liver specialist may ask the patient to quit alcohol or avoid particular red meat, trans fats, processed carbohydrates, and high-fructose fat. Lifestyle changes also include a moderate-intensity exercise of 30 to 60 minutes around twice or thrice a week. Obese patients may require to shed 500 to 1,000 calories daily.

The liver specialist may ask the patient to avoid some dietary or herbal supplements to reduce scarring. It is essential to discuss the potential risks before making any lifestyle or nutritional changes with the liver specialist.

If you’re looking for the best liver treatment in Mumbai. Please book an appointment with an experienced liver specialist, Dr. Gaurav  Gupta

What Is Cirrhosis?

Our liver has the ability to repair and regenerate itself. However, as it gradually builds scar tissue, it is less able to function correctly. As the number of scarring increases, the liver’s circulatory flow decreases. Further, the essential functions of the liver are compromised. In some cases, this may lead to liver failure and even death. Globally, over one million people die every year from Cirrhosis.

Dr. Gaurav Gupta, Head of Liver Transplant and HPB Surgery at Fortis Hospitals, Mumbai has over decades of experience in handling complex liver surgeries and treatment of Liver Cirrhosis too. Due to his vast expertise and experience, he is known to provide the best liver transplant in Mumbai.

Now, let’s know about Cirrhosis, its diagnosis, and treatment.

 

Prolonged liver damage leads to a condition known as Cirrhosis of the liver. In this condition, the liver becomes hard and nodular. Liver tissue is replaced by fibrosis. Once cirrhosis sets in, liver damage becomes irreversible. The cirrhotic liver becomes incapable of regenerating.

Classification of Cirrhosis

1. Compensated Cirrhosis

It is merely a damaged liver that is still relatively functional.

2. Decompensated Cirrhosis

It represents the advanced stage of cirrhosis where signs and symptoms of liver dysfunction start.

Why can Cirrhosis be Dangerous?

Cirrhosis leads to various complication like

  • Ascites (fluid in the abdomen)
  • Edema (fluid in limbs)
  • Variceal bleeding (bloody vomiting)
  • Confusion (encephalopathy)
  • Kidney dysfunction (hepatorenal Syndrome)
  • Lung complication (Hepatic hydrothorax, Hepatopulmonary syndrome)
  • Liver cancer

The risk of death with intractable ascites and variceal bleed can be quite high. Patients with ascites that are not controlled with medications (intractable ascites) have a mortality risk of almost 70% within one year.

A single episode of infection in patients with ascites (SBP) carries a 50% one-year mortality risk.

If complications are not controlled when the liver ceases to function, your Liver Transplant Surgeon in Mumbai may recommend liver transplantation.

Approximately 5% of people with cirrhosis develop hepatocellular carcinoma (HCC). It’s the most common form of liver cancer.

Symptoms of Cirrhosis 

Progression of liver damage from early-stage fibrosis to cirrhosis usually takes years to manifest symptomatically. There are often few, if any, symptoms in the early years.

When symptoms occur, they are sometimes misdiagnosed, ignored, or attributed to other possible causes. However, as the ailment progresses, the symptoms may get more apparent. These symptoms include:

  • Fatigue
  • Confusion
  • Weakness
  • Itching
  • Loss of appetite
  • Weight loss
  • Nausea
  • Easy bruising
  • Jaundice
  • Swelling of ankles, feet, and legs
  • Abdominal bloating from the ascites

Causes of Cirrhosis

The most common causes of cirrhosis are:

  1.  Alcohol-related liver disease: It is typically associated with heavy alcohol intake over several years.
  2.  Hepatitis B: It is a prevalent cause of cirrhosis.
  3. Hepatitis C: It is one of the frequent causes of cirrhosis and the leading indicator for liver transplants.
  4. Non-alcoholic fatty liver disease: People with diabetes, high blood pressure, obesity, and high cholesterol are more prone to cirrhosis. This is becoming one of the most common causes of Liver cirrhosis with the increasing incidence of lifestyle diseases in our population.

 

Some of the rare causes of cirrhosis include:

  • Primary Sclerosing Cholangitis
  • Hereditary diseases like Wilson’s disease
  • Autoimmune hepatitis
  • Hemochromatosis
  • Celiac disease
  • Medication

 

Diagnosis of Cirrhosis

1. Liver biopsy:

It is the most accurate method for the diagnosis of cirrhosis and its stage. With advancements in Radiological tools, Liver Biopsy is rarely done these days to diagnose cirrhosis.

2. An ultrasound or Magnetic Resonance Elastography:

These are non-invasive ways to detect cirrhosis.

3. Blood tests and imaging tools (CT scan and MRI):

These can be used to monitor disease progression.

Treatment of Liver Cirrhosis

  • Many cases of cirrhosis have been manageable before they progress and require a liver transplant in Mumbai.
  • The management of cirrhosis depends primarily on the cause and severity of the disease.
  • But the treatment should begin immediately after its diagnosis.
  • Cirrhosis is generally not curable except through liver transplantation.

You should take the below steps to decrease the progression of liver scarring, including:

  • Avoid taking alcohol and medicines that can cause injury to the liver.
  • Avoid over-the-counter herbal agents and supplements, as some have been associated with liver injury.
  • Cirrhosis elevates the risk of prescription-drug liver injury. So, all prescriptions should be carefully reviewed for effects on the liver.
  • Avoid raw shellfish that may contain bacteria. It could potentially cause severe infection in people with advanced liver disease.
  • Screening and vaccination for hepatitis A and  hepatitis B
  • Antiviral therapy for hepatitis B and hepatitis C.
  • Screening and treatment of secondary causes of cirrhosis such as ursodiol for bile duct blockages.
  • Nutrition plays an important role in managing Cirrhosis patients.

The management of cirrhosis should begin as soon as you’re diagnosed with the condition. After the diagnosis, you should always consult a qualified and experienced Liver Specialist in Mumbai to seek the best treatment.