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4th LEVEL FIBROSIS with SLEEVE GASTRECTOMY. LIVER TRANSPLANT?

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Shortly I will explain what happen to my father .
My dad did a surgery to lose weight (Sleeve gastrectomy ) the surgery succeed but the Surgeon notice that the liver shape is abnormal so after 3 days from the surgery , we went to another doctor specialized in internal medicine and we made some tests (blood , Ultrasonic and MRI) and we found that he has a fibrosis in his liver 4th level fibrosis .
My father doesn't suffer from anything his eyes are normal and he has NO ascites and he doesn't have any Hepatitis viruses .
With the knowledge , my grandfather and 2 of my uncle died because of a liver diseases .
One of them diagnosed with Wilson's disease and the other died before we know. We went to other doctor and he insure that my dad has a Wilson’s disease and he takes a medicines now but I want you to see the report and answer these question
1- Is my dad will need liver transplant .
2- Do you think the liver with the medicine will work fine ?
3- Is the liver will recover to be normal ?
4- What is the probability that D-penicillamine will work good in the case of my dad ?
5- Any further advice ?

Please see it , and Evaluate the situation and tell me



Regards
Haitham Alsaab
TEL: 00966500706765
EMAIL: [email protected]

Category: Hepatologist

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Category: Hepatologist
 27 Doctors Online

Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
From your post I can understand that your father underwent sleeve gastrectomy to control blood glucose.
And he was found to have chronic liver disease.
The workup for chronic liver disease showed that he has Wilson Disease and he is on D penicillamine.
Now the answer for your questions.
1. To know whether he needs liver transplant, we need to calculate the MELD score. To calculate this we should know the following - Bilirubin, creatinine and INR. In the attached document I am not able to see creatinine and INR.
2. If it is just Wilson disease, the liver will work fine with medications. But the doctor has said there might be an autoimmune component as well and it was to be evaluated during the follow up.
3. The liver is cirrhotic. Cirrhosis of liver is irreversible. So the liver will not become normal with medications. Only the worsening is prevented.
4. D.pencillamine works well for Wilson Disease.
5. Periodic follow up with the doctor very important.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K


Patient replied :

the inr
was there it was
1.21
0.01 high
the normal is 1.2
creatinine was normal completlly normal
so what do u think ?
I attached some old test before 4 months if u don't mind look at it


Hi,
As per MELD score he does not need liver transplant as of now.
He needs to continue taking D penicillamine and to be on regular follow up with his doctor.
Let me know if you have any more questions.
Regards,
Dr.R.K.


Patient replied :

thnx a lot

But I want to ask what is the food that he should avoid completely?
is he alowed to eat meet ?
what about fat and olive oil ?


Hi,
Food that is minimal in copper should be consumed.
Beef, pork should be avoided until copper levels are stabilized. Occasional egg white, chicken is consumption is allowed.
Speak to dietician if vegetarian as many things any vegetarian diet may have high copper content.
Many vitamin supplements contain copper. Consult your doctor before taking them.
Avoid smoking/alcohol completely. Avoid dry fruits, chocolates, mushrooms.
Consultation with dietician is adviced
Thank you


Patient replied :

Hi,
Food that is minimal in copper should be consumed.
Beef, pork should be avoided until copper levels are stabilized. Occasional egg white, chicken is consumption is allowed.
Speak to dietician if vegetarian as many things any vegetarian diet may have high copper content.
Many vitamin supplements contain copper. Consult your doctor before taking them.
Avoid smoking/alcohol completely. Avoid dry fruits, chocolates, mushrooms.
Consultation with dietician is advised
Thank you



Dr. Ratnakar Kini
Category: Hepatologist
Experience: 
Fellowship - DM - TN Dr.MGR Medical UniversityResidency - TN Dr.MGR Medical University Medical School - Stanely Medical College, TN Dr.MGR Medical University
Dr. Ratnakar Kini and 4 other Medical Specialists are ready to help you

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