A. Your report suggests your husband decompensated while on
peginterferon treatment.
I would recommend you stop all treatment including thrombomax and
peginterferon and ribavirin, and your husband come over for further
assessment.
I am concerned about the rapid rise in bilirubin over at relatively
short duration of time, and I am concerned about complications such
as portal vein thrombosis, spontaneous bacterial peritonitis, or
variceal bleeding. We will also counsel you and your family about
live donor liver transplant at the same time
In response to your specific queries:
- Cost for live donor transplant here is S$260,000 with GST. But
this does not include pretransplant assessment or management. In view
of the rapid rise of bilirubin, I think your husband should come to
us sooner rather than later.
- If fatty liver is >30% then they are not suitable as potential
liver donor. Please ask them to start losing weight and we can do the
biopsy in Singapore.
- We accept both genetically related, or emotionally related donor.
But the donor must be emotionally related, like being a friend or
colleague.
- It is difficult for me to decide on management through email
without assessing the patient clinically. I will strongly advise your
husband come over early for treatment.
Many studies have showed among patients with decompensated cirrhosis,
half died within 2 years. But the actual survival depends on the
individual patient's condition. Again, it is not possible to comment
without assessing the patient clinically.
