Liver failure caused by dengue advice on liver transplant?

[Goatonthemountain]

My d-in-law has collapsed from v recent dengue infection. She is in icu in Brazil. Her INR is 4.1 her brain fog has been cleared through dialysis but liver deemed not to be functioning. I have her blood results but don't want to bore the list with numbers. (She's a non-drinker non-smoker). I am speaking to my son through WhatsApp and understand that they are worried about bleed in surgery, but if they don't transplant, that will surely be worse? Is there a critical period for transplant? (They have paperwork to fill in ) Sorry to blast this off but feeling very lost and far away.

[AyrshireK]

Sorry to hear about the situation your son and daughter in law find themselves in. Very scary for you all. I guess they just have to go with the treatment and advice on offer. With an INR of 4.1 she is showing the signs of serious issues of blood clotting which is a huge risk factor for transplant and is a symptom of the Dengue Fever. Found on line "Liver transplantation becomes a difficult proposition in lieu of hemodynamic compromise, bleeding, and organ impairment seen during dengue infection."

Are they holidaying in Brazil or living there? All very scary times.

In the UK you have to be fit enough for transplant yet needy enough and obviously stable enough to wait for a suitable donor - we have the super urgent list where people are given priority if they are failing quickly.

I don't think anyone here will be able to give any clear indication of what might happen next but I do hope they manage to stabilize her and give indication of next steps.

Thoughts with you all,

Katie

[Goatonthemountain in reply to AyrshireK]

Katie, tha k you so much for your really helpful quote - they are UK citizens, working there at least for another year. I'm assuming that the medics have in-deprh Dengue experience just so worried about possible surgical /transplant complications. Thank you again and very happy wishes for 2025 x

[Goatonthemountain in reply to Goatonthemountain]

I forgot to add she as seen to have "severe flapping" a term I can't find anywhere!

[AyrshireK in reply to Goatonthemountain]

Flapping is commonly called asterixis in liver disease "Asterixis is a condition characterized by involuntary flapping movements of the hands, often associated with impaired liver function. It is most commonly correlated with liver diseases such as cirrhosis or hepatitis."

It is often seen in Hepatic Encephalopathy when toxins are building up in the brain.

[Goatonthemountain]

Thank you I couldn't find info on it. Her Encephalopathy levels improved, now coherent, waiting for coagulation level result x