Elevated Liver Enzymes

[jvarnold]

Hey everyone!  Its been a while since I've been on here. Haven't had much news until this past week. We were told that JD has extremely high liver enzymes and that he has fatty liver. They want him to lose 15 lbs but he's mostly muscle so we don't know where he'll lose it from... His nephrologist suggested we go to the transplant center because they have specialists there who can treat him. Plus, I received my blood and urinalysis results and they came back good! So, this Friday (4/12) we're headed to San Antonio for our evaluation/tests. His nephrologist said we'll have to be patient because they don't know why his liver is inflammed. Has anyone had any liver issues before transplant? They may have to do a liver biopsy but since he's on PD they may have to do the procedure through the jugular.    So, we'll see! Staying positive! 

[st789]

Had that experience during P.D and the reason is because of my Hep. B.  After was giving Interferon shots and on Epivir medication my liver became stable.  what is the cholesterol level?

Hope it helps

[texasstyle]

Fatty liver is when your liver has more than 10% of it's weight in fat. Alcohol and excess calories for example, can lead to this. Over time a fatty liver inflames & can harden turning into cirrhosis. The liver enzymes that first show something is off with the liver are ALT's & AST's. You might see them on a blood lab report. Among other things an elevation in these can be a sign of hepatitis. Hepatitis itself means "inflammation of the liver" but I would be asked to check for viral hepatis B or C. I'm not saying it is this but just one of the "it could be" things. Always better on the safer side.

[Chris]

Has CMV been checked?
I had that problem soon after transplant, but still can occur with anyone. An infectious disease doctor would be a good idea to seek if there is a slight chance the transplant center does not or GP?PCP doctor does not.
 
Good Luck and hope this is figured out soon.

[jvarnold]

We received the results from JD's  CT scan and the nephrologist thinks it may be NASH... Since he is on PD they are going to have to do the biopsy procedure through the jugular on Monday, the 17th. They think its because of his diabetes that got him to this point. We will still be able to have the kidney transplant regardless of the results of the biopsy but that his liver will eventually fail. The doctor was in such a rush because he was just out of doing a liver transplant, and 2/3 of the time he was on the phone! It really made me upset because this is heartbreaking news and he was chipper and trying to leave quickly.  We're trying to be positive. Please keep us in your thoughts...

[MooseMom]

What is NASH?  I'm getting the feeling it's nothing good.  What's this about his liver eventually failing?  The doctor couldn't spare the time to explain things to you?  He may think he is God, but he is not...he should have given you a lot more information.  From your original post, I am assuming that you are being tested as a possible kidney donor?  If so, would it be possible for you to eventually donate part of your liver?  Is that an option?

How on earth do they do a liver biopsy through the jugular?  Can they put him to sleep for this procedure?  What a frightening time for you, made even worse by a lack of compassion and information from the doctor.  I am so sorry this is happening to you.  It must feel overwhelming, so many things to take in at once.  Just focus on the biopsy for now...get that done so that you both and your medical team can make a plan of action.  In the meantime, we're thinking of you and are offering all of the support possible.

[paris]

Non alcoholic steatohepitis = Nash.  My brother in law has this.  It all has to do with fatty liver disease, diabetes.  It leads to liver failure. 

I want to learn more about the liver biopsy through the juguar, too.   

A transplant seems so simple on paper.  And then we learn all the little things that have to be in perfect order for a transplant to happen.  We'll be watching to learn how things turn out. Please keep up posted.   

[jvarnold]

From what I remember, the biopsy they will be doing will require him to be asleep and they will send a very small tube with a claw at the end down the jugular, through the vessels and down to the liver (a 30-1 hour procedure) and the doctor said they do get a good sized portion. Now...how they pull that back up through has me cringing! This is all I know how they do it. I'd like to do more research on it myself. I'm overwhelmed but I have to stay calm for him.

I am cleared to donate my kidney to him, but the doctor said that living donor liver transplant is risky(?) and that theres a lot of bleeding for the donor and a lot more pain. He said its too risky and that they only do cadaver donors. I thought, If they're already in there to take my kidney take part of my liver too! I'm willing.

Paris - Yeah transplant does seem simple on paper! It is taking quite a toll on us. It hurts because he's 30, athletic and if you looked at him you wouldn't think he was sick at all. He has diabetes so they think that's how he aquired fatty liver disease.

I appreciate everyones thoughts through this time. Taking it one day at a time! 

[monrein]

I've had a liver biopsy...one lobe is coarse and strange looking apparently although my enzymes are Ok..but they just went in with a needle and got out a couple of pieces.  Apparently I interviewed the doctor the entire time about his family, his training, his immigration to Canada, his adjustment to a new culture, his career choice, the whole nine yards.  I remember none of it but the nurse told me later that she'd never heard the guy have to talk so much and she'd worked with him for over a year. 

I'd like to hear how the biopsy through the jugular goes and I do wish you both the best.  I'm guessing that this way of doing things might minimize any potential bleeding but who knows.