75 Kpa - compensated or decompensated.

[Zaka99]

Following on from my other post earlier today, I am a bit confused by some reading I have been doing today on this site and others. Many Fibroscan charts indicate that a score over 30kpa means you have a decompensated liver.

So I scored 75kpa on my last scan (the highest score possible) indicating I have a decompensated liver.

However my LFT's are normal again after being mildly high. I show no symptoms of a decompensated liver and from what I have read on here, it suggests my liver is compensated as it seems to be coping.

I have Hep C (currently Epclusa medication treatment) and used to drink heavily before April this year.

So the question I have is qhat actually do I suffer from? Compensated or decompensated!? Is it possible to have such a high Fibroscan result and still have a compensated liver, a liver that is coping!?

Confused......

Zak

[AyrshireK]

Hi Zaka99, Fibroscan can be highly elevated if you have ongoing inflammation. Have you even been told you have cirrhosis? We've got other members on here who hit the full 75kPa and ended up they didn't have cirrhosis just inflammation and kPa score went down after the source of inflammation was dealt with - I note you are still undergoing treatment for Hep C.

You will need an ultrasound scan every 6 months at conclusion of treatment to check for changes in the liver & this would confirm cirrhosis if present. Cirrhosis means the liver is more prone to development of hepatic cancers and some of the newer Hep C treatments are also a risk factor - regular monitoring ensures any changes are picked up soon enough and at a stage when treatment is possible (and often successful).

If you are symptom free then you are NOT decompensated. Decompensated cirrhosis is when the liver is struggling to fulfill even its major functions and patients with this level of cirrhosis are likely to have ascites, portal hypertension with or without varices, symptoms of Hepatic Encephalopathy and might be jaundice. This is the dangerous and life threatening degree of cirrhosis.

Compensated cirrhosis is when the liver is still coping to do at least its major functions although there are still likely to be other symptoms.

Have a read at the British Liver Trust page about cirrhosis at:- britishlivertrust.org.uk/li...

In all my years membership of the forum I have never heard that fibroscan can tell between decomp/comp cirrhosis. The Fibroscan score chart indicates where Hep C is the cause of liver damage a kPa score over 15 would be considered cirrhosis, however, as aforestated ongoing inflammation can also elevate kPa score.

You are best to check with your medical team for a thorough discussion of your personal situation.

All the best, Katie

[Zaka99 in reply to AyrshireK]

Hi Kate,

My specialist nurse wrote to my doctor (I received a copy) stating I needed to start Hep C treatment right away as my Fibroscan results were indicating I had 'advanced cirrhosis'. So I have always taken this as a diagnosis.

I was quite surprised by this at the time but felt treatment for the Hep C was obviously important as this and the 20 plus years of on and off binge drinking and clearly caused some problems.

The fibroscan charts I mentioned are online (possibly not on this site - I have been really so much today) but several definitely state a dividing line of 30kpa between compensated and decompensated which is what began to totally confuse me.

I'm seeing my specialist again this Friday so I will think about what more I want to discuss with her about my situation.

The people that you mentioned with the high 75kpa score whilst having the Hep C infection untreated (like me) - can you recall if their fibroscan results returned back to a normal state once the virus was cleared?

Best wishes, Zak

[AyrshireK in reply to Zaka99]

The folks mentioned certainly dropped their kPa scores. They probably didn't return to normal or low, with an advanced Hep C infection it is likely that damage has occurred and yes you might have cirrhosis but if you are symptom free then it isn't decompensated. Go by symptoms not scores - my hubby has cirrhosis with symptoms yet has never been told a single score, never been told compensated, decompensated. His hepatologist won't give him a fibroscan 'cos she said it will add nothing to diagnosis 'cos they already know he has cirrhosis.

He just gets regular scans and monitoring - his cirrhosis is due to auto-immune liver disease.

I know in the UK owning to funding they weren't for a long time treating Hep C until it had reached cirrhosis stage which seemed really short sighted. Believe it or not we had a lady posting on here, hubby had hep c untreated which led to cirrhosis and transplant, hubby had 13 calls to hospital before finally getting transplant with lots of complications. New liver developed Hep C too and you know they wouldn't treat the new liver till it too had cirrhosis (what a waste of time, money and eventually life).

Take a list of questions in when you visit your doctor and get them answered, make the most of your appointments.

Katie

[Hidden in reply to AyrshireK]

13 calls that is truly horrendous, what on earth was going on. I had one false start and that was “traumatic” enough (that’s a bit OTT for me because I’m too laissez faire but you know what I mean 😁).

[Porphyrogennetos]

I think decompensated simply means you're symptomatoc, the liver is unable to fulfill it is duties, as it is not able to compensate the damage done. It is not something determined by fibroscan.

If you have varices, HE or ascites, that is usually considered a sign of decompensation, I believe.