7 ms·

The flip side to the liver's amazing duties in the body is the catastrophic impact on health when it fails. A failed liver takes out basically every body system

by mhalle 9y ago

The flip side to the liver's amazing duties in the body is the catastrophic impact on health when it fails. A failed liver takes out basically every body system. When the liver can't break down bilirubin, you get jaundice and itch all over. When the liver becomes cirrhotic, blood can't move through it, increasing pressure in the portal vein and precipitating life-threatening bleeds in the stomach and esophagus. For an extra bonus, clotting factors are manufactured in the liver, so these bleeds can be uncontrolled. The spleen enlarges and gobbles up white blood cells, compromising immunity. Ammonia and other yet not fully understood toxins that the liver can't filter cross the blood-brain barrier and cause hepatic encephalopathy, ranging from brain fog to coma. Liver disease is also tied to hepatorenal syndrome (kidney failure) and hepatopulmonary syndrome (lung damage), both of which can be sudden and fatal. Ascites (retention of fluid) also accompanies cirrhosis, often requiring paracentesis, which in turn is correlated with sepsis that the compromised immune system can't fight (also often fatal). Low Vitamin D in cirrhotic patients leads to osteoporosis, including vertebral fractures. Inability to process protein leads to muscle wasting and weight loss, reducing strength and immunity. And finally, cirrhosis is correlated with an increased risk of liver cancer. The cure for any of these conditions? Transplant, if you're lucky and the other systems aren't too badly damaged. Everything else is just holding on. And to get a transplant? You have to be sick enough and sufficiently close to death that you're eligible, but strong enough to survive major surgery. No insurance in the US? They won't even assess you. A liver transplant saved my life three years ago. I've lived this list of symptoms. My debt to the universe is to educate when possible, to console when necessary.

tr1ck5t3r 9y ago
Liver - Latin for life. Doctors used to say, you are what you eat, how many have eaten a lb of Ox liver in a sitting? Hint - Its better than Red Bull!
JumpCrisscross 9y ago
> No insurance in the US? They won't even assess you. Do you have a source that goes into the reasoning behind this? I could guess, but I'd prefer to give the subject the respect it deserves.
- jlrbuellv 9y ago
  Not OP, but I received a bone marrow transplant 6 months ago, and the amount billed to my insurance so far has exceed 2 million USD. So I assume no transplant team could survive without someone agreeing (in advance) to pay the bill for the transplant and post transplant related care. If I had walked in with a big enough wad of cash, it's possible I could have got on the list too, but my case has pretty much gone as smoothly as possible, with complication I could see the bill approaching a much bigger number,
  - Chris2048 9y ago
    If this makes thankful you have insurance, maybe the number is inflated. It's not unheard of for the net amount paid to be far less.
    - mhalle 9y ago
      Any patient in the situation should be thankful for insurance. When your liver is failing, you have your hands full. The only major variable you should try to optimize is wait list time. Outcomes are roughly comparable across centers and are monitored by the government.
    - Mz 9y ago
      From what I have read about transplants, I would not automatically assume the figure above is inflated. They seem to generally be quite expensive.
  - chimeracoder 9y ago
    > Not OP, but I received a bone marrow transplant 6 months ago, and the amount billed to my insurance so far has exceed 2 million USD. Transplants are expensive, but the amount billed to your insurance is not a meaningful number in any way. Hospitals don't actually expect insurers to pay that; they set the number absurdly high as a starting point for the back-and-forth negotiations. This is particularly true for very expensive procedures which are almost always paid for by private insurance - both because of the expense, but in some cases by law. (On that note, even looking at the amount paid by your insurance is misleading as well, because if you're on private insurance, you're paying not just for your own care, but to cover the care of people who are on Medicare and Medicaid, since private insurers are required to cover the costs of those patients' care as well. This is especially true for high-end, expensive, and/or chronic or terminal treatments like dialysis.)
DougWebb 9y ago
My ex-wife is still recovering from her second liver transplant. The first one was when she was 20, due to a genetic disease that causes sudden liver failure around that age. That time, she went from ER to transplant to recovery in just a few days, because of how quickly she became sick enough to move to the top of the list. They never told her that liver transplants are pretty much always temporary, at least with the immuno-suppressant drugs that were available most of the past 20ish years. Even with drugs, most people's bodies are constantly attacking the foreign liver and damaging it beyond its ability to repair itself. 20 years is a pretty good run; hers lasted 22. This time around, she was in the hospital for two months (seemed much longer) while they tried to keep her alive. She went through all the symptoms you mentioned. Towards the end she suffered full-on dementia from the toxins in her brain. After two months of suffering, she lost her will to live, and told me and her family that she was giving up. I was sure she'd be gone by the end of the week, but that night the miracle happened; a compatible liver was available and she was at the top of the list. The next day, after a very long surgery (working around 22 years of scar tissue from the first transplant) she got a healthy new liver. She remained in the hospital two more months, mostly in rehab, while her brain returned to normal (mostly) and she learned to walk again. It took months after going home for her to be strong enough to fully care for herself. Unfortunately, the decades of drugs and months of liver failure pushed her kidneys past their limit. She's not on dialysis yet, but most likely she will need a transplant before the year is up. It's just a matter of time, and she's trying to find a living donor. If she can find one, she can get the transplant before she gets too sick again, which will make recovery much easier. Organ transplants are absolute miracles of modern medicine, but we need artificial organs. Whether they're completely mechanical, natural organs grown artificially, or custom gene-spliced organs to prevent rejection, we need them. There aren't enough organs available now to meet the need, and the patients who get them have to go through hell first. And the ones who don't, don't survive at all.
- klipt 9y ago
  > we need artificial organs Or a way to farm organs in the lab. If self driving cars succeed in massively reducing accident deaths (yay!) an unintended consequence will be huge shortfalls in donatable organs.
Razengan 9y ago
> My debt to the universe is to educate when possible, to console when necessary. I don't have any liver related problems, or know/knew anyone with them, but I must thank you for having that sentiment.
CamelCaseName 9y ago
Can you give some advice on how to keep my liver healthy?
- oh_sigh 9y ago
  Don't drink too much, exercise, eat a healthy diet, dont use unclean needles, insist a condom be worn during sex
- blonky 9y ago
  My docs told me, while I was waiting for a transplant, that fatty liver is a problem. Even though a donor looks healthy, their liver can be too fatty for transplant. Eat right and exercise.
zaptheimpaler 9y ago
I have a liver disease of unknown cause - doctors have investigated every cause under the sun for many years without success, and it looks like ill need a transplant at some point. Would you mind if i contact you with a few questions?

by mhalle 9y ago

tr1ck5t3r 9y ago

Liver - Latin for life. Doctors used to say, you are what you eat, how many have eaten a lb of Ox liver in a sitting? Hint - Its better than Red Bull!

JumpCrisscross 9y ago

> No insurance in the US? They won't even assess you. Do you have a source that goes into the reasoning behind this? I could guess, but I'd prefer to give the subject the respect it deserves.

jlrbuellv 9y ago
Not OP, but I received a bone marrow transplant 6 months ago, and the amount billed to my insurance so far has exceed 2 million USD. So I assume no transplant team could survive without someone agreeing (in advance) to pay the bill for the transplant and post transplant related care. If I had walked in with a big enough wad of cash, it's possible I could have got on the list too, but my case has pretty much gone as smoothly as possible, with complication I could see the bill approaching a much bigger number,
- Chris2048 9y ago
  If this makes thankful you have insurance, maybe the number is inflated. It's not unheard of for the net amount paid to be far less.
  - mhalle 9y ago
    Any patient in the situation should be thankful for insurance. When your liver is failing, you have your hands full. The only major variable you should try to optimize is wait list time. Outcomes are roughly comparable across centers and are monitored by the government.
  - Mz 9y ago
    From what I have read about transplants, I would not automatically assume the figure above is inflated. They seem to generally be quite expensive.
- chimeracoder 9y ago
  > Not OP, but I received a bone marrow transplant 6 months ago, and the amount billed to my insurance so far has exceed 2 million USD. Transplants are expensive, but the amount billed to your insurance is not a meaningful number in any way. Hospitals don't actually expect insurers to pay that; they set the number absurdly high as a starting point for the back-and-forth negotiations. This is particularly true for very expensive procedures which are almost always paid for by private insurance - both because of the expense, but in some cases by law. (On that note, even looking at the amount paid by your insurance is misleading as well, because if you're on private insurance, you're paying not just for your own care, but to cover the care of people who are on Medicare and Medicaid, since private insurers are required to cover the costs of those patients' care as well. This is especially true for high-end, expensive, and/or chronic or terminal treatments like dialysis.)

DougWebb 9y ago

My ex-wife is still recovering from her second liver transplant. The first one was when she was 20, due to a genetic disease that causes sudden liver failure around that age. That time, she went from ER to transplant to recovery in just a few days, because of how quickly she became sick enough to move to the top of the list. They never told her that liver transplants are pretty much always temporary, at least with the immuno-suppressant drugs that were available most of the past 20ish years. Even with drugs, most people's bodies are constantly attacking the foreign liver and damaging it beyond its ability to repair itself. 20 years is a pretty good run; hers lasted 22. This time around, she was in the hospital for two months (seemed much longer) while they tried to keep her alive. She went through all the symptoms you mentioned. Towards the end she suffered full-on dementia from the toxins in her brain. After two months of suffering, she lost her will to live, and told me and her family that she was giving up. I was sure she'd be gone by the end of the week, but that night the miracle happened; a compatible liver was available and she was at the top of the list. The next day, after a very long surgery (working around 22 years of scar tissue from the first transplant) she got a healthy new liver. She remained in the hospital two more months, mostly in rehab, while her brain returned to normal (mostly) and she learned to walk again. It took months after going home for her to be strong enough to fully care for herself. Unfortunately, the decades of drugs and months of liver failure pushed her kidneys past their limit. She's not on dialysis yet, but most likely she will need a transplant before the year is up. It's just a matter of time, and she's trying to find a living donor. If she can find one, she can get the transplant before she gets too sick again, which will make recovery much easier. Organ transplants are absolute miracles of modern medicine, but we need artificial organs. Whether they're completely mechanical, natural organs grown artificially, or custom gene-spliced organs to prevent rejection, we need them. There aren't enough organs available now to meet the need, and the patients who get them have to go through hell first. And the ones who don't, don't survive at all.

klipt 9y ago
> we need artificial organs Or a way to farm organs in the lab. If self driving cars succeed in massively reducing accident deaths (yay!) an unintended consequence will be huge shortfalls in donatable organs.

Razengan 9y ago

> My debt to the universe is to educate when possible, to console when necessary. I don't have any liver related problems, or know/knew anyone with them, but I must thank you for having that sentiment.

CamelCaseName 9y ago

Can you give some advice on how to keep my liver healthy?

oh_sigh 9y ago
Don't drink too much, exercise, eat a healthy diet, dont use unclean needles, insist a condom be worn during sex
blonky 9y ago
My docs told me, while I was waiting for a transplant, that fatty liver is a problem. Even though a donor looks healthy, their liver can be too fatty for transplant. Eat right and exercise.

zaptheimpaler 9y ago

I have a liver disease of unknown cause - doctors have investigated every cause under the sun for many years without success, and it looks like ill need a transplant at some point. Would you mind if i contact you with a few questions?