Are liver transplants approved for people in their late 70's?

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KathleenW
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Date Joined May 2010
Total Posts : 80
   Posted 5/23/2010 5:57 AM (GMT -7)   
My mother was diagnosed with NASH (non alcoholic fatty liver disease) about 15 years ago. She continued to have her couple of drinks before dinner and it also has come to light her doctor had her on three drugs that cause liver damage. Cirrhosis set in but she was not diagnosed until about a month ago. Originally we were told she was not "dying" but it or complications would get her in the next few years. She is in transitional care with the hope we could clear her mental fog and build up her strength so she could have a bit more time at home. A new doctor was assigned per my request who is trying to get her on the transplant list. But, I wonder if she is too old to qualify at 77. Anyone have experience with this? Her liver has gotten much worse in the past month and the doc is telling me without a transplant, she has only 6 months to live. Also, wondering about live donor transplants. She is also a diabetic (type 2) but otherwise no problems and her kidney function is very good. I am at my wits end trying to get the docs to give me straight answers. No one has mentioned live donor transplant - but we have two Centers of Excellence (Mayo and the University of Minnesota) in our back yard that have been doing them for over a decade... I found out about the live donor on line.
Life is painful, suffering is optional

Post Edited (KathleenW) : 6/1/2010 2:03:34 PM (GMT-6)


KathleenW
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Date Joined May 2010
Total Posts : 80
   Posted 5/23/2010 6:24 AM (GMT -7)   
I should add a few more facts... She is on all the drugs including the Lactlose, but her mental state continues to get worse. We have her on a "liver" diet at the TCU, low salt, restricted fluids. Her mental state does not improve but is getting worse. She has 5 to 6 stools a day, but the doc is concerned about bleeding although there are no ruptures that were found two weeks ago. I so much want her mental state to clear enough so we have her back if even for a few weeks. Any help or pointers you can give would be great.

**David**
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   Posted 5/23/2010 8:58 AM (GMT -7)   
Is your mother still drinking? If so, she would have to prove she had been sober for at least 6 months or a year, depending on the hospital. I had a transplant at Massachusetts General Hospital. My hepatologist explained that if I reached 70, they would take me off the waiting list. They said that giving a transplant to someone that age would be foolish and a waste. Your hospital may have different rules. **David**

hep93
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Date Joined Jul 2005
Total Posts : 12014
   Posted 5/23/2010 11:52 AM (GMT -7)   
Kathleen, welcome to the forum. As one sober alcoholic to another, congratulations on quitting. As for your mother, I had heard that the cut-off is 70. I'm sure other factors come into the decision, though. Her having diabetes is no small matter, as it can cause complications. The only thing I can suggest for her mental state is to increase the Lactulose. Sometimes Xifaxan is also added. It could just be that her liver disease is worsening and that nothing can be done. If she is up to the testing they will do, I suggest going to Mayo for a second opinion. They will definitely be honest and if there is any possibility of saving her life, they'll give it a try.

Remember to take care of yourself during all this.

Hugs,
Connie
hep93
Forum moderator - Hepatitis
 
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland


KathleenW
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Date Joined May 2010
Total Posts : 80
   Posted 5/23/2010 12:43 PM (GMT -7)   
Thanks, I was was afraid there is a cut off of 70 or so. Mom has not had a drink since diagnosis - at this point, someone would have to bring it to her as she is in transitional care and can't do anything without help. She is pretty much in a wheelchair. Family has been asked to come to sit with her at meals as she will not eat or falls asleep if we are not there pushing. Mom was never a problem drinker until the last couple of years. I suspect we are at the end. We are checking with Mayo and Fairview to see about a transplant. Thanks and any other information people have would be very much appreciated. I have not been real impressed with the medical community thus far. One of the problems we have is mom is so sick, we can't take her out of the Transitional Care Unit to get her anywhere for another opinion. However, I am feeling better about the new doctor assigned to her case - he is a straight shooter and is aggressive in his approach to treatment.

hep93
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Date Joined Jul 2005
Total Posts : 12014
   Posted 5/23/2010 12:50 PM (GMT -7)   

Well, Mayo is not going to come to her, of course.  That's why I said "if she's up to the testing."  They may not want to tell you anything on the phone without seeing her.  Even if she has had previous tests, they want to do their own.  I'm glad you feel positive about her new doctor, though.  Please keep us posted.

Hugs,

Connie


hep93
Forum moderator - Hepatitis
 
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland


arneeb
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Date Joined Nov 2009
Total Posts : 2350
   Posted 5/23/2010 12:56 PM (GMT -7)   
Kathleen if you read the thread No Treatment.. you'll read my partner and I's journey from U of M to Mayo... by far and away the Mayo Clinic was on the feet.. we were told at the U of M it would take three weeks to get an appointment for evaluation.. Mayo it was like available within days... also the U of M did not do a real good job with his brother Steve who died five years ago... and some of it was lack of early intervention and detection... he had ESLD.. was approved for the transplant but no testing was done in the months prior... and he had large tumors in the liver that went undetected.. and U of M directed that disaster.. Mike was given excellent care at the Mayo they just couldn't do anything for him... I also was going to look into live donor.. I would have given my life to have him here...hope this helps.. time is of the essence and the Mayo will be the most responsive .. that's been our experience.. and you don't have time to test out this and that one.. thoughts and prayers are with you... Sandi
There is no pit so deep that He is not deeper still... Corrie Ten Boom


KathleenW
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Date Joined May 2010
Total Posts : 80
   Posted 5/23/2010 1:15 PM (GMT -7)   
Thanks - Mayo will be the first choice for sure. The doc is working to see which program they can get her in. Her age of course is going to be a challenge. We'll get her to where she needs to be for testing - none has been done for transplantation thus far. We should have answers this week on if Mayo (or anyone else) will accept her in the program due to her age. I will read more threads. Thanks to all of you! You are indeed angles!

KathleenW
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Date Joined May 2010
Total Posts : 80
   Posted 5/23/2010 1:55 PM (GMT -7)   
One final note: My drinking was out of hand too. Unlike my mother, I found the program of AA and I have been in recovery since May 4, 2008. Mom's final gift to me is "life" again. She gave me my first chance at life when I was born, and now through her liver disease she has shown me the path I made a decision to follow a little over two years ago was indeed the path to life. I just got my liver testing results back from my clinic - everything looks very normal. My doctor states if there was damage from my binge drinking, it has resolved itself. I will be 50 this year. Message to my mom: Thank you mom, through your experience and suffering, you have taught me yet another good life lesson. I love you mom! Kathleen
Kathleen
Life is painful, suffering is optional

Post Edited (KathleenW) : 6/7/2010 9:04:38 PM (GMT-6)


hep93
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Date Joined Jul 2005
Total Posts : 12014
   Posted 5/23/2010 2:27 PM (GMT -7)   

Kathleen, my mother also served as a bad example for me.  I saw myself becoming her and that was a huge factor in my going to AA and getting sober, almost 24 yrs. ago. 

By the way, NALD is usually called NASH--non-alcoholic steatohepatitis (fatty liver), in case you are doing any searches for it. 

Hugs,

Connie



hep93
Forum moderator - Hepatitis
 
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland


KathleenW
Regular Member


Date Joined May 2010
Total Posts : 80
   Posted 5/23/2010 5:00 PM (GMT -7)   
Thanks for the clarification on the fatty liver disease. I feel bad for my mother as she was not a problem drinker for at least 70 years. Goes to show though, it does not take long for that nasty disease to ruin your life - or take it away - no matter how old you are. Congrats on being sober for 24 years one day at a time.

KathleenW
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Date Joined May 2010
Total Posts : 80
   Posted 5/24/2010 6:01 PM (GMT -7)   
Today I set up a caring bridge website called peggyowens at caringbridge.com Mom had a UTI and her potassium levels are still low. They think this is what is causing the confusion. Spoke with the nurse from the new doc and authorized brining in a specialist. I am not sure we'll be able to get her into a program for a transplant. I mentioned we are the same exact blood type and my liver appears to be in good shape based on the liver tests I just had done with my annual exam. Wondering if this will help get her in at 77 - I am hopeful, but understand this is an up hill battle. Dad is upset, but getting the house in order, but being as up beat as possible. They have been married for 57 years.

hep93
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Date Joined Jul 2005
Total Posts : 12014
   Posted 5/24/2010 6:22 PM (GMT -7)   

Kathleen, hopefully you are healthy enough to be a live donor, but they will first have to determine if your mother is.  She has to be ill enough to warrant a transplant, but also well enough to live through surgery and the post-op period.  Testing is very extensive and includes psychological testing.  If she were to make it through the evaluation period, your willingness to be a donor could impact their decision, especially if they are concerned about her age.  Your dad is going to need a lot of support.

Hugs,

Connie


hep93
Forum moderator - Hepatitis
 
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland


shadowsghost
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Date Joined Apr 2008
Total Posts : 489
   Posted 5/24/2010 6:28 PM (GMT -7)   

Katthleen, I am so sorry to hear about your mum, I wish you the best in this struggle! I saw your question about transplant relating to age, my understanding is that at a certain point a persons age does not make for a good candidate for transplant because it is a lenghty surgery, alot of anesthesia and a tough recovery time with the added issue of anti rejection drugs. The risk of fatal complications are very high and survival slim. I dont believe the Dr that told you it would be a waste of an organ was the right way to say why she may not get a transplant, it is a fine balance of sick enough for surgery and being well enough to recover. From experience the UTI causes the same type of confusion as high ammonia levels, also any type of infection in someone with organ failure. Hopefully you see a change in her since addressing the UTI.

Sue


Adapt yourself to the life you have been given; and truly love the people with whom destiny has surrounded you.


KathleenW
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Date Joined May 2010
Total Posts : 80
   Posted 5/24/2010 9:08 PM (GMT -7)   
The doctor thinks it is worth a shot. He thinks mom is a decent candidate because her diabetes is under control, her kidney function is very good and she does not have any lung or cardiovascular issues. All her problems stem from the liver. Recent studies have shown that people in their 70's have only slightly less success than younger people in transplantation of the liver. I suspect those mature folks likely were in good health other than liver disease. There is a good argument that we all are living longer and really, 70 is the new 60 just like 50 is the new 40 and so on. The real problem seems to be not enough organs for transplantation. I have always said, we should have an "opt out" rather than "opt in" program in this country - make people take the time and trouble to "opt out".... Shortages would not be nearly as big of an issue, if any at all. I am no expert, you all have way more personal experience than I do. Maybe someday technology can solve this problem and allow us to "grow" our own spare parts.... Not in time for my mom or many of the rest of the people on this site, but we can dream can't we?

arneeb
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Date Joined Nov 2009
Total Posts : 2350
   Posted 5/24/2010 9:41 PM (GMT -7)   
Hey if you can get her stabilized... maybe you can find someone who willing to do a "pilot" transplant with your mom.......... and u being living donor... I myself would have been willing to do that for Mike......... so ... keep on keeping on.. don't ever give up until it's over....... and it ain't over until it's over.. what's true for one will not always be true for another... keep on.. keep your face to the sun.. you'll never see the shadows... (less ur a ground hog) Sandi
There is no pit so deep that He is not deeper still... Corrie Ten Boom


child4
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Date Joined Jun 2009
Total Posts : 107
   Posted 5/25/2010 11:45 AM (GMT -7)   

Hello -

just want you to know that my mom was 74 and was transplanted.  Unfortunaley, she could not fight an infection.  The liver functioned perfectly.  My mom never drank, so that is not an issue.


KathleenW
Regular Member


Date Joined May 2010
Total Posts : 80
   Posted 5/25/2010 7:10 PM (GMT -7)   
Sorry about your mom and the infection child4 - such a shame the liver was working fine and something else happened to cut her time short.

I'll keep you all posted on the updates on my mom. It is a long-shot on the transplant - at 77 and the fact at the end she was drinking, but we'll move forward with any option at this time until they slam the door shut on all options.

I appreciate all of your comments and encouragement. Thanks for everything!

KathleenW
Regular Member


Date Joined May 2010
Total Posts : 80
   Posted 5/26/2010 8:51 PM (GMT -7)   
Mayo asked to have mom's medical records sent down via fax. The transplant coordinator told me 70 is typically the cut off, but they have started transplanting more people in their very early 70's. Being 77 the transplant route is a long shot, but since I am willing to donate part of mine, I think they are at least going to review her status. Stay tuned. I should know something soon. I am calling Fairview University tomorrow.

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 5/26/2010 9:15 PM (GMT -7)   

Way to go, Kathleen!  You will never know unless you try.  Good for you for trying to do what you can.  Even if she's not a transplant candidate, you will know that you tried.  Good luck!

Hugs,

Connie


hep93
Forum moderator - Hepatitis
 
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland


arneeb
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Date Joined Nov 2009
Total Posts : 2350
   Posted 5/26/2010 10:14 PM (GMT -7)   
So push for other treatments too... trials... research... you just go... for it... and when they say no ... go somewhere else... and just try... Sandi 

There is no pit so deep that He is not deeper still... Corrie Ten Boom


shadowsghost
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Date Joined Apr 2008
Total Posts : 489
   Posted 5/27/2010 2:39 PM (GMT -7)   

You go girl

Sue


Adapt yourself to the life you have been given; and truly love the people with whom destiny has surrounded you.


KathleenW
Regular Member


Date Joined May 2010
Total Posts : 80
   Posted 5/27/2010 4:52 PM (GMT -7)   
Tried to close the deal by sending down my test results - full liver, history, all my wellness screenings etc. All my numbers are excellent so.... I also let them know I run and work out every day along with no alcohol for over 2 years... We'll see....
Life is painful, suffering is optional


KathleenW
Regular Member


Date Joined May 2010
Total Posts : 80
   Posted 5/31/2010 2:32 PM (GMT -7)   
Mom is fading fast. I don't think she will last long enough to get a transplant. Her memory is almost gone - I was out there for two hours this morning and she forgot I was even there. She has a very hard time waking up after she sleeps, which is basically anytime she is not eating. She still eats, but I think only because we are there cheering her on... I am so sad.
Life is painful, suffering is optional


arneeb
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Date Joined Nov 2009
Total Posts : 2350
   Posted 5/31/2010 3:11 PM (GMT -7)   
My thoughts and prayers are with you.. Sandi
There is no pit so deep that He is not deeper still... Corrie Ten Boom

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