LT + Bypass?

Hello all. I was diagnosed about a year ago with NASH/cirrhosis and in January with a small primary HCC. I have no symptoms. The liver problems first showed in liver function tests associated to type 2 diabetes.

Resection is not possible as I have portal hypertension. I have had a successful TACE. In assessment prior to listing for transplant, an angiogram has shown I have stenosis in two of my coronary arteries. Again, I have no symptoms but need a bypass because of the strain the heart is put under during transplant.

Amid much talk of "it's a good job we've found these things so early" (I'm 58) I find I have no symptoms, feel well and I'm facing two serious operations. It all seems to take a long time and is becoming very stressful.

The question now Is whether they do the bypass first and the transplant when I recover or do them both on the same day. I'm waiting to be seen by the cardio surgeons.

Have any of you had experience of this scenario? Any thoughts would be most appreciated. Best regards.

3 Replies

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  • I was in a similar situation three years ago aged 63: no symptoms, small HCC treated by TACE, slight artery problem but after angio, cardiologist decided against stenting as the risk was considered low. They continued to monitor and after 6 months on the transplant list, I had the operation and a quick recovery - much to do with the fact that I had been "well" before the operation. I know it is easier said than done, but keeping well, active and upbeat pre transplant was good for me. Best of luck.

  • I'm currently in a similar predicament except I had a stent some 10 years ago. The cardiologists are now looking at the various test results to see if my heart can take the strain of a TP. I'm 62 and generally in good health so I'm hoping to go on the list in about a month (after holiday :) ). It is stressful but keeping a positive attitude is helping. I'm not considered suitable for TACE and a transplant is the only hope of medium term survival but, hey, no worse than the last 18 years have been. Keep your chin up and realise that they don't want to risk your heart giving up. That will end your life very quickly :-). Good luck, Phil

  • Thanks for the replies. I do keep pretty positive most of the time and I'm trying to be as active as I can so that I'm as fit as possible for whatever lies ahead. Most of the time I see the logic that says it's good that they've found these problems early and that I'm young enough to make a good recovery. But I also suppose it's natural to be impatient for the ops to happen so that I can get on with the rest of my life. Good luck and bests, Joe.

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