Urgent Help Needed: Post-Surgery Complications in Liver Cancer Patient

Help my mother, issues arising after liver cancer surgery?

My mother is 53 years old and has hepatitis C, cirrhosis, and a malignant tumor.
She underwent liver resection surgery on November 24, where approximately four centimeters were removed.
After the surgery, her liver is not functioning properly, and her coagulation function has completely failed.
She is experiencing continuous bleeding and is being maintained through blood transfusions.
She has now been intubated and is showing signs of renal failure and ascites.
The doctors have indicated that the situation is not optimistic.

Is there any way to save my mother since her liver is not functioning? Is a liver transplant feasible? When can a liver transplant surgery be performed? At the time of the surgery, wasn't her coagulation function assessed? Why is this issue arising now? Her blood pressure is continuously low.
What other complications can we expect? What is the worst-case scenario? Please help my mother.
She has been a widow since her twenties and raised five children as a cleaner.
We have finally all settled down, and she has worked for over 25 years at her job and is now at retirement age.
It feels like fate is not allowing her to have a good life.
Please tell us what we can do to save her.

Minghui, 30~39 year old female. Ask Date: 2005/11/27

Dr. Huang Zhihui reply Surgery

Based on your description, your mother may be experiencing postoperative complications due to liver dysfunction and liver failure, leading to multiple organ failure and coagulopathy.
Although clinicians thoroughly assess a patient's condition before surgery to determine whether to proceed, there are still many variables that cannot be completely anticipated.
As a result, the mortality rate due to liver failure following such surgeries remains as high as 5%.
This is primarily because these patients often have pre-existing liver cirrhosis and impaired liver function, which naturally increases the risk of postoperative liver failure.
Given your description, your mother's current condition does appear to be quite serious.
However, what she may need now is support for her cardiopulmonary function and prevention of subsequent complications.
A liver transplant may not be beneficial at this stage, so it is advisable to collaborate closely with the clinical team and maintain open communication with the physicians.
I believe the clinicians will do their utmost to provide care for your mother.

Reply Date: 2005/11/27

More Info

I'm truly sorry to hear about your mother's condition. It sounds like she is facing a very challenging situation after her liver surgery. Based on the information you've provided, it appears that your mother is experiencing severe post-operative complications, including liver failure, coagulopathy (loss of blood clotting ability), renal failure, and ascites (fluid accumulation in the abdomen). These complications can arise, especially in patients with pre-existing liver conditions such as cirrhosis and chronic hepatitis C.

Understanding the Situation
1. Liver Function and Coagulation: The liver plays a crucial role in producing proteins necessary for blood clotting. When the liver is compromised, as in your mother's case, it can lead to significant bleeding issues. Even if her coagulation function was assessed before surgery, the underlying liver disease can lead to unpredictable outcomes post-surgery. The risk of liver failure is higher in patients with pre-existing liver conditions, and unfortunately, the surgical stress can exacerbate these issues.

2. Liver Transplantation: In cases of acute liver failure, liver transplantation can be a potential option, but it depends on several factors, including the overall health of the patient, the extent of liver damage, and the availability of a suitable donor. Given your mother's current state, her medical team would need to evaluate her thoroughly to determine if she is a candidate for transplantation. This evaluation includes assessing her liver function, overall health, and the presence of any other complications.

3. Management of Complications: Your mother’s current treatment likely involves supportive care, which may include:
- Blood Transfusions: To manage bleeding and support her blood volume.

- Diuretics: To help manage ascites and reduce fluid overload.

- Renal Support: If her kidneys are failing, she may require dialysis.

- Nutritional Support: Ensuring she receives adequate nutrition, possibly through enteral feeding if she cannot eat.

4. Future Risks and Prognosis: The prognosis in cases like your mother's can be quite variable. If her liver function does not improve, she may face further complications, including infections, worsening renal function, and multi-organ failure. The worst-case scenario could involve progression to irreversible liver failure, which can be fatal.

Steps You Can Take
- Communicate with the Medical Team: It’s crucial to maintain open lines of communication with your mother’s healthcare providers. They can provide the most accurate information regarding her condition and treatment options. Don’t hesitate to ask questions about her prognosis, potential for liver transplantation, and what you can do to support her care.

- Consider Palliative Care: If the prognosis is poor and the focus shifts from curative treatment to comfort, palliative care can help manage symptoms and improve quality of life. This approach can be beneficial for both your mother and your family during this difficult time.

- Support for the Family: Caring for a loved one in such a critical condition can be emotionally and physically exhausting. Seek support from family, friends, or professional counselors to help you cope with the stress and emotional burden.

Conclusion
While the situation is undoubtedly dire, it’s essential to focus on what can be done to support your mother through this challenging time. Engage with her healthcare team, explore all available options, and ensure she receives the best possible care. Remember that you are not alone in this; many families face similar challenges, and support is available.

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