3 ms·

Well this is good news. But how much of a whole liver does a recipient need, now, to get good enough liver function? I thought they were famous for growing ba

Well this is good news. But how much of a whole liver does a recipient need, now, to get good enough liver function? I thought they were famous for growing back.

sp332 3y ago
If the liver gets full of hard scar tissue, it can physically constrain the hepatocytes from making more liver tissue. https://www.news-medical.net/news/20200824/Large-animals-with-ailing-livers-can-grow-new-organ-in-lymph-nodes-from-their-own-hepatocytes.aspx https://www.news-medical.net/news/20200824/Large-animals-wit...
sandworm101 3y ago
Surprisingly little. Most of the liver stand by at idle ready to filter intermittent massive doses of things, such the stuff arriving in your bloodstream after a big meal. This is what makes many liver diseases so evil. A person can live basically free of symptoms for many years as their liver struggles and is progressively damaged by some substance (alcohol). Until one day the amount of remaining functional liver dips slightly below the minimum needed to sustain daily functions. After decades of drinking, over the course of a month a functional alcoholic can go from being a happy drunk to a patient dying in hospital in need of a new liver.
- _a_a_a_ 3y ago
  I'm rather unclear about the speed of regrowth. From one source (the web?) It was a matter of years, yet talking to a herpetologist (edit: hepatologist. Blame voice recognition) in a pub, she said it can regrow 80% of itself in a matter of weeks. Assuming a healthy liver, how fast is regrowth? Assuming a cirrhosed liver , how would that affect regrowth time? TIA.
  - username135 3y ago
    When a liver has cirrhosis, its scarred beyond functional repair which means no growth.
- raisedbyninjas 3y ago
  So alcoholics should do a periodic stress test of binge eating to get an early warning.
  - ajuc 3y ago
    Just do blood tests for liver diseases markers every year. Even if you're not an alcoholic - there's many other diseases that result in similar damage. For example if you have asthma and especially if you have colitis ulcerosa or crohn's disease - you're at much higher risk of PSC - an autoimmune liver disease which does basically the same thing as decades of drinking.
    - boredemployee 3y ago
      Tangentially, I just found out in a routine test that I have a condition called "gilbert's syndrome" [0]. It's harmless tho. It came from my parents, it seems. My dad died of liver cancer, but I don't know if he was diagnosed with that syndrome and if they were related. [0]. https://www.mayoclinic.org/diseases-conditions/gilberts-syndrome/symptoms-causes/syc-20372811 https://www.mayoclinic.org/diseases-conditions/gilberts-synd...
      - rrrrrrrrrrrryan 3y ago
        I've got Gilbert's as well - found out about ten years ago during some routine blood work. The only thing I've noticed is that dehydration hits me a little harder than most people. If I don't drink enough water throughout the day I get fatigued, and if I don't drink enough water after a night out I get pretty gnarly hangovers. This is just comparing me to my peers though, and might not be due to my Gilbert's at all, but the fact that these things have been linked to Gilbert's in studies means it's possible they're related. Anyway, staying hydrated never hurts, so thought I'd pass that along in case it helps you too.
        boredemployee 3y ago
        Thanks for your comment! What you said makes a lot of sense, I started taking more care of my health in the last 45 days, I took several tests, etc. and then I discovered this condition. The nutritionist, not yet knowing about Gilbert's syndrome, asked me to drink 2 to 3 liters of water a day and what I noticed was a huge reduction in the sleep I felt during the day. I also realized that caffeine consumption also bothers me and I'm trying to reduce it. Don't even get me started on the hangover, every time I go out I already know I'm going to have a hellish next day! It's great to know that I'm not the only one and that someone else continues to drink even though they have a "problem" with their liver, so I feel less guilty!
- hinkley 3y ago
  One of our dogs had days to live by the time we found out he had a congenital defect that caused a fibrous liver. In retrospect some parts of his personality may have been symptoms, but we were wrecked.
  - derefr 3y ago
    What aspects of his personality would you suspect?
    - hinkley 3y ago
      Very easily satisfied by activity. Afterward I was less convinced he was a chill dude and more concerned he was easily exhausted.
Jaepa 3y ago
They are to an extent. Cirrhosis is permanent. Other conditions such as fatty liver are reversible-ish. The issue is that the liver is basically fully functional until after you’ve destroyed ~88% of it. For a tortured analogy it’s a lot like a DB. Most of them time you’re well under your total capacity. Even short spikes in queue length aren’t an issue. But once you hit the tipping point there are cascading failures.
- skissane 3y ago
  > Cirrhosis is permanent Cirrhosis has been observed to reverse in some individuals. It is still permanent for most patients, and we shouldn’t give people with it false hope, but its reversal isn’t impossible. Most commonly cirrhosis reversal is observed after chronic viral hepatitis is cured by antiviral treatment. There are even a handful of clinical case reports of alcoholic cirrhosis reversing after extended abstinence from alcohol, even though that is a rather rare outcome. I remember reading a case report (sorry can’t find it right now), of a Japanese alcoholic diagnosed with liver cirrhosis, who then was severely disabled by a stroke, and had to be moved to a nursing home. He never drank again because he physically couldn’t drink without nursing staff assistance, and they weren’t going to give him any alcohol. Roughly 20 years later, his cirrhosis had disappeared. Of course, this is a rare outcome (he likely had favourable genetics, plus rarely does an alcoholic find relapse physically impossible), but it shows it can happen. This is why there is a lot of hope that some of the liver disease drugs currently in the clinical pipeline may be able to reverse cirrhosis (and if not them, maybe their future successors). However, current trials are focusing on fibrosis not cirrhosis. And they run into the difficulty that what counts as cirrhosis seems reasonably clear in everyday clinical practice, but how to reliably detect its existence/progression/improvement/reversal to a clinical trial standard of certainty is difficult and a matter of dispute (No I don’t have cirrhosis, as far as anyone knows, but my aunt had it-albeit asymptomatic, it was only discovered on autopsy after she suddenly and unexpectedly died from a cardiac arrest while asleep one night-which is actually very common, majority of people with liver disease die from heart disease before the liver disease kills them, or even causes any observable symptoms-but I do have intermittent hypochondria, and in some of my past hypochondriac episodes I have become rather obsessed with reading papers on this and related topics.)
uslic001 3y ago
Patients with cirrhosis have significant scarring of the liver that disrupts the normal liver architecture. When liver cell regenerate on this abnormal scaffolding it forms regenerative nodules surrounded by scar tissue that prevents then from doing their normal filtering.

Well this is good news. But how much of a whole liver does a recipient need, now, to get good enough liver function? I thought they were famous for growing back.

sp332 3y ago

If the liver gets full of hard scar tissue, it can physically constrain the hepatocytes from making more liver tissue. https://www.news-medical.net/news/20200824/Large-animals-with-ailing-livers-can-grow-new-organ-in-lymph-nodes-from-their-own-hepatocytes.aspx https://www.news-medical.net/news/20200824/Large-animals-wit...

sandworm101 3y ago

Surprisingly little. Most of the liver stand by at idle ready to filter intermittent massive doses of things, such the stuff arriving in your bloodstream after a big meal. This is what makes many liver diseases so evil. A person can live basically free of symptoms for many years as their liver struggles and is progressively damaged by some substance (alcohol). Until one day the amount of remaining functional liver dips slightly below the minimum needed to sustain daily functions. After decades of drinking, over the course of a month a functional alcoholic can go from being a happy drunk to a patient dying in hospital in need of a new liver.

_a_a_a_ 3y ago
I'm rather unclear about the speed of regrowth. From one source (the web?) It was a matter of years, yet talking to a herpetologist (edit: hepatologist. Blame voice recognition) in a pub, she said it can regrow 80% of itself in a matter of weeks. Assuming a healthy liver, how fast is regrowth? Assuming a cirrhosed liver , how would that affect regrowth time? TIA.
- username135 3y ago
  When a liver has cirrhosis, its scarred beyond functional repair which means no growth.
raisedbyninjas 3y ago
So alcoholics should do a periodic stress test of binge eating to get an early warning.
- ajuc 3y ago
  Just do blood tests for liver diseases markers every year. Even if you're not an alcoholic - there's many other diseases that result in similar damage. For example if you have asthma and especially if you have colitis ulcerosa or crohn's disease - you're at much higher risk of PSC - an autoimmune liver disease which does basically the same thing as decades of drinking.
  - boredemployee 3y ago
    Tangentially, I just found out in a routine test that I have a condition called "gilbert's syndrome" [0]. It's harmless tho. It came from my parents, it seems. My dad died of liver cancer, but I don't know if he was diagnosed with that syndrome and if they were related. [0]. https://www.mayoclinic.org/diseases-conditions/gilberts-syndrome/symptoms-causes/syc-20372811 https://www.mayoclinic.org/diseases-conditions/gilberts-synd...
    - rrrrrrrrrrrryan 3y ago
      I've got Gilbert's as well - found out about ten years ago during some routine blood work. The only thing I've noticed is that dehydration hits me a little harder than most people. If I don't drink enough water throughout the day I get fatigued, and if I don't drink enough water after a night out I get pretty gnarly hangovers. This is just comparing me to my peers though, and might not be due to my Gilbert's at all, but the fact that these things have been linked to Gilbert's in studies means it's possible they're related. Anyway, staying hydrated never hurts, so thought I'd pass that along in case it helps you too.
      - boredemployee 3y ago
        Thanks for your comment! What you said makes a lot of sense, I started taking more care of my health in the last 45 days, I took several tests, etc. and then I discovered this condition. The nutritionist, not yet knowing about Gilbert's syndrome, asked me to drink 2 to 3 liters of water a day and what I noticed was a huge reduction in the sleep I felt during the day. I also realized that caffeine consumption also bothers me and I'm trying to reduce it. Don't even get me started on the hangover, every time I go out I already know I'm going to have a hellish next day! It's great to know that I'm not the only one and that someone else continues to drink even though they have a "problem" with their liver, so I feel less guilty!
hinkley 3y ago
One of our dogs had days to live by the time we found out he had a congenital defect that caused a fibrous liver. In retrospect some parts of his personality may have been symptoms, but we were wrecked.
- derefr 3y ago
  What aspects of his personality would you suspect?
  - hinkley 3y ago
    Very easily satisfied by activity. Afterward I was less convinced he was a chill dude and more concerned he was easily exhausted.

Jaepa 3y ago

They are to an extent. Cirrhosis is permanent. Other conditions such as fatty liver are reversible-ish. The issue is that the liver is basically fully functional until after you’ve destroyed ~88% of it. For a tortured analogy it’s a lot like a DB. Most of them time you’re well under your total capacity. Even short spikes in queue length aren’t an issue. But once you hit the tipping point there are cascading failures.

skissane 3y ago
> Cirrhosis is permanent Cirrhosis has been observed to reverse in some individuals. It is still permanent for most patients, and we shouldn’t give people with it false hope, but its reversal isn’t impossible. Most commonly cirrhosis reversal is observed after chronic viral hepatitis is cured by antiviral treatment. There are even a handful of clinical case reports of alcoholic cirrhosis reversing after extended abstinence from alcohol, even though that is a rather rare outcome. I remember reading a case report (sorry can’t find it right now), of a Japanese alcoholic diagnosed with liver cirrhosis, who then was severely disabled by a stroke, and had to be moved to a nursing home. He never drank again because he physically couldn’t drink without nursing staff assistance, and they weren’t going to give him any alcohol. Roughly 20 years later, his cirrhosis had disappeared. Of course, this is a rare outcome (he likely had favourable genetics, plus rarely does an alcoholic find relapse physically impossible), but it shows it can happen. This is why there is a lot of hope that some of the liver disease drugs currently in the clinical pipeline may be able to reverse cirrhosis (and if not them, maybe their future successors). However, current trials are focusing on fibrosis not cirrhosis. And they run into the difficulty that what counts as cirrhosis seems reasonably clear in everyday clinical practice, but how to reliably detect its existence/progression/improvement/reversal to a clinical trial standard of certainty is difficult and a matter of dispute (No I don’t have cirrhosis, as far as anyone knows, but my aunt had it-albeit asymptomatic, it was only discovered on autopsy after she suddenly and unexpectedly died from a cardiac arrest while asleep one night-which is actually very common, majority of people with liver disease die from heart disease before the liver disease kills them, or even causes any observable symptoms-but I do have intermittent hypochondria, and in some of my past hypochondriac episodes I have become rather obsessed with reading papers on this and related topics.)

uslic001 3y ago

Patients with cirrhosis have significant scarring of the liver that disrupts the normal liver architecture. When liver cell regenerate on this abnormal scaffolding it forms regenerative nodules surrounded by scar tissue that prevents then from doing their normal filtering.