the Risks of Jaundice and Liver Transplant Complications

Can jaundice be life-threatening?

Hello Doctor: My husband is a liver transplant patient, but after the transplant, his liver enzymes increased, and the doctors couldn't find the problem.
They suspected a biliary issue, so they performed ERCP, but after three attempts, his condition worsened, although his liver enzymes decreased.
His bilirubin level is currently over 19, while his liver enzymes have dropped from 200-300 to 40 and 80.
The doctors have conducted ultrasounds, CT scans, and liver biopsies without finding any rejection or cause.
They now suspect that the liver he received (from mainland China) may not have been in good condition, and some of the bile ducts in the liver may have already necrosed.
Therefore, they recommend a second transplant.
However, my husband's bilirubin remains very high.
I would like to ask Dr.
Hsu a few questions:
1.
Is a second transplant very risky compared to the first one? According to American doctors, it is similar to the first transplant but more complex.
However, we have a friend who also had a liver transplant in mainland China, and when he returned, he had liver issues.
His wife donated her liver for a second transplant, but unfortunately, he passed away due to massive bleeding.
These concerns weigh heavily on my mind.
2.
Given my husband's high bilirubin levels, is there a risk to his life? His liver function seems to be improving, but his bilirubin continues to rise.
His doctor mentioned that high bilirubin only causes yellowing of the skin and itching, and does not impact life.
Is that true?
3.
Regarding my husband's current bilirubin situation, does taking URSO help reduce bilirubin levels? If it is a 100 mg medication, what would be the best way to take it?
I appreciate your attention to these matters, and I am very grateful for your help.
We will always remember your kindness.
Thank you!

Ms. Hsu, 20~29 year old female. Ask Date: 2005/08/28

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello! Your husband's situation is quite complex, and without his medical history for reference, it is difficult to conduct a thorough online assessment and interpretation.
Regarding whether your husband needs a second liver transplant, it is advisable to consult a liver transplant surgeon.
Professor Li Bo-Huang from National Taiwan University Hospital is an authority in this field and can provide a professional evaluation.
You may bring your husband's medical summary and imaging reports for Professor Li's review.
Elevated bilirubin levels indicate that liver function has been affected, which is indeed concerning.
It is crucial to identify the underlying cause as soon as possible.
URSO can promote bile metabolism, but its usage should be determined by a physician based on the patient's condition.

Reply Date: 2005/08/28

More Info

Understanding the complexities surrounding jaundice and liver transplant complications is crucial, especially in the context of your husband's situation. Liver transplantation is a life-saving procedure for patients with end-stage liver disease, but it comes with its own set of risks and complications, particularly when there are issues like jaundice and bile duct problems.

1. Risks of Second Liver Transplantation: The risks associated with a second liver transplant can be higher than the first due to several factors. The patient's overall health, the condition of the remaining liver tissue, and the presence of complications from the first transplant all play a role. While some medical professionals may assert that the procedure is similar to the first, the reality is that each case is unique. The complexity increases with prior surgeries, potential adhesions, and the body's response to previous immunosuppressive therapy. The case you mentioned about a friend who experienced complications after a second transplant highlights the potential dangers. It's essential to have a thorough evaluation by a transplant surgeon who can assess the specific risks based on your husband's medical history and current condition.

2. High Jaundice Levels and Life Threats: Jaundice itself, characterized by elevated bilirubin levels, can indicate significant underlying liver dysfunction. While jaundice may not directly threaten life, it is often a symptom of more severe liver issues that can lead to life-threatening conditions. The fact that your husband's liver function tests are improving while his bilirubin levels remain high is concerning. It suggests that there may be an obstruction in the bile ducts or other complications that are preventing bilirubin from being excreted properly. Elevated bilirubin can lead to complications such as pruritus (itching), but it can also indicate a risk of liver failure if not addressed. Therefore, it is crucial to continue monitoring his condition closely and to explore all possible avenues for treatment.

3. Use of URSO (Ursodeoxycholic Acid): URSO is often prescribed to help improve bile flow and reduce bilirubin levels in certain liver conditions. However, its effectiveness can vary based on the underlying cause of jaundice. If the jaundice is due to a blockage or damage to the bile ducts, URSO may not be sufficient on its own. The standard dosage for URSO can vary, but it is typically taken in divided doses with food to enhance absorption. It is essential to follow the prescribing physician's instructions regarding dosage and frequency. If your husband is taking 100 mg, it would be best to consult his doctor for specific dosing recommendations tailored to his condition.

In summary, your husband's situation is complex and requires careful management by a specialized medical team. It is vital to have open discussions with his healthcare providers about the risks and benefits of any proposed treatments, including the possibility of a second liver transplant. Regular monitoring and prompt intervention for any complications are essential to improving his prognosis. Your concerns are valid, and seeking clarity from his medical team will be crucial in navigating this challenging time.

Similar Q&A

Understanding Liver Coma: Causes, Risks, and Transplant Options

My sister is currently in Canada. Last week, she mentioned that her eyes were yellow and her urine was also yellow. On the 23rd, she felt unwell and was taken to the emergency room. The doctors have diagnosed her with gallstones and hepatic encephalopathy. She is about seven mont...

Dr. Li Xuanshu reply Gastroenterology and Hepatology
Hello! Although it is unclear what caused your sister's acute liver failure, based on the information in the letter, liver transplantation must be considered. We strongly recommend consulting with a physician in Canada regarding the possible causes of your sister's cond...

Understanding Liver Complications After Chemotherapy: A Patient's Journey

Hello, my father underwent surgical treatment for rectal cancer two years ago and was doing well. However, he experienced a recurrence two years later and was transferred to the hematology department at the same hospital. He has been taking oral chemotherapy and receiving weekly ...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: I would like to discuss the reasons for liver function deterioration. Your attending physician must have pondered and searched for causes without success, which is why they responded that the cause of liver deterioration could not be identified. (1) Infection (bacterial, v...

Liver Transplant: Risks for Donors and Options for Patients with Cancer

My mother has cirrhosis and liver cancer. Yesterday, she underwent radiation therapy for the cancer cells. Since I am living abroad, I cannot be with her, and I have informed my sister that the cirrhosis may further endanger my mother's life. It would be best for her to have...

Dr. Fan Sheng reply Oncology
Vegetables: Liver transplantation is really not my area of expertise; I recommend consulting a surgical team with experience in liver transplants. I apologize for that.

Understanding the Risks of Cancer Related to Jaundice Symptoms

Hello, doctor. I researched some symptoms of jaundice in adults. In this stage, hepatitis is the primary cause of jaundice, especially chronic hepatitis B and C. Some patients may progress to cirrhosis or develop liver cancer, which can severely affect liver function and cause ja...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: It is recommended to monitor the changes in the indices. If the jaundice is caused by diseases of the pancreas, bile ducts, or liver, the indices will gradually increase. At that time, a physician will evaluate what kind of examinations should be arranged. You should also ...