Cirrhosis of the liver

Question

Hello,

My daughter has been diagnosed at the middle of december to have a very severe fibrosis of the liver with beginning cirrhosis. Is it not mandatory that she will be put on a waiting list for liver transplantation immediately? Unfortunately, the CF physician is very hesitant, which I do not understand. Probably you could tell already an opinion about this. We can only talk to the doctor at the beginning of january. Of course, this does not get out of our minds....
Best regards,
H.O.

Answer

Dear questioner,

the urgency for listing for a liver transplantation follows from the course of the CF liver disease until now and depends on the dynamics of the deterioration of the liver function. In general, the progress of CF liver disease is slow, however, other not CF-related causes of the liver disease have to be taken into account. The diagnosis of liver disease is the result of several findings: laboratory findings in the course of time, imaging and (more rare in CF) the result of a biopsy. Results of an ultrasound investigation have to be interpreted with caution, as in CF the picture shows often a pattern like a severe fibrosis without a massive limitation of function. Furthermore it is of high importance if there is a collateral circulation due to portal hypertension with the finding of varices in the esophagus and with an enlargment of the spleen. For the therapeutic management also the condition of the lung and the age of the patient have always to be taken into account.

With kind regards,
Dr. H. Ellemunter

18.02.2013