Why can't the liver rejuvenate itself with PBC or AIH?

[Jtxx]

[Hidden]

Jtxx,

This is the information that I've found as I've also wondered about this.

The liver is the only internal human organ capable of natural regeneration. As little as 25% of a liver can regenerate into a whole liver. (WOW!)

This is a question asked to Mellisa Palmer, M.D. (GI, Hepatologist Doc.)

What would happen to a PBC patient if part of the liver were surgically removed?

Answer: If part of a PBC patients liver were surgically removed and cirrhosis is present, as in stage 4, the liver could not regenerate. If cirrhosis were not present, the liver could regenerate, but the newly regenerated liver would still have PBC. When a PBC patient has the entire liver removed a donor can donate a part of his/her liver. It will eventually grow to a normal size liver.(She didn't say if this new normal sized liver could get PBC.)

This information is only a start, maybe others will have more......hope so.

Take care!

[Saundrella in reply to Hidden]

I've read where the partial living donor portion (transplant) will eventually acquire the PBC but it takes a long while. I will be going down this road, soon, perhaps. I'm sixty-five and my daughter has my blood type and wants to give me part of her liver. Problem is, I'm not sick enough, yet. I could bleed at any time, though, and that would raise my MELD score 10 points, making me eligible to at least talk transplant at that point. Problem is: Once I get sick enough, I may be too old. Doctors have mentioned a cut off age of 70 but I think it depends a lot on how the seventy-year old functions. I function very well except for my PBC. I'm in the process of trying to work around this age related problem, somehow. It's a dilly :o)

[Hidden]

In my opinion and I'm no medic, just got PBC (!!) but as far as I read in text books and online, the liver can regenerate itself. (Apparently you don't have to have a full liver transplanted, only partial and it will regrow.)

I think with PBC for instance, once you are diagnosed with PBC you always have the antibodies and if they are responsible for attacking the bile ducts which in turn then starts to irritate and inflame the liver, I think it could be a fair opinion that as our livers are attempting to repair themselves whilst at the same time having bile leaking thus a pretty ongoing battle.

I reckon with urso if it proving that blood tests are looking good then the battle is also looking good.

Also as far as I keep reading if a patient has a liver transplant and then all is well and good, there is no such guarantee that in time the PBC won't restart as regardless once we have PBC we have it and a transplanted liver in future could be under attack once again.

I can't say a comment with AIH as don't know much about it other than what it stands for as with hepatitis it stands for inflammation of the liver so perhaps there could be more of a battle going on but also I thought that was the reason steroids were used for this condition, they are anti-inflammatory so perhaps this battle is pretty much the same if with PBC & AIH one fights with this and urso?

[Hidden in reply to Hidden]

Hi, That is also my understanding of PBC.

[zipitydoo]

The way I understand it is that if you have a new liver your immune system will start attacking the bile ducts in that one. Patients that have had a transplant still take urso.

[busylady]

Hi Jtxx,

Agree with all the above comments, when I went for a transplant assessment last year ( for late PBC) they said even if you get a new liver, you will still have the genetics and AMA that means that eventually the side effects from PBC will return. However early intervention with URSO should minimise the damage caused by the bile and therefore preserve the ducts.

.

Sorry I dont know much about AIH but I would assume that the genetics would be similar to PBC - as in they are still there even if your liver regenerated it would keep on being destroyed by our own bodies?

I am going for my second transplant assessment at the end of June...............will keep you all informed of the outcome. I may ask the question again to test if they are giving me consistent info ha ha

Keep strong ,and as healthy as we can while we are "out there"................. I take heart and strength from you all, and from the fact that, this is a "lonely" disease at times, but here, I know that none of us are alone.

[catherine69]

I know of two ladies who have both had a transplant due to PBC and both now have PBC in the new livers, in fact one of the ladies is on this sight.

[busylady in reply to catherine69]

From a selfish/personal point of view I would love to hear from people who have had the transplant, both good and bad experiences.............I think I have a big decision to make in June and I know the health care professionals are there to offer us support and the "facts" but there is nothing like hearing it from the patients point of view.

Any info greatfully recieved.

x

[Jtxx in reply to busylady]

My mum had a transplant in 1992 when she was 45 yrs old (diagnosed aged 42 with cirrhosis). She died aged 57. She had a good quality of life for 11 of those years. The last year she progressively declined until she died in Jan 2004. She was never on Urso (before or after transplant) although she took 2 autoimmune suppressants (for anti rejection purposes) after her transplant . She was told that she would not be cured of the PBC and that it could attack the liver again but as it took 45 yrs to kill off the old one it could take a long time to affect the new one. In the end they think the anti rejection drug cyclosporine caused her to have kidney problems (known side effect), and subsequent failure, and that it was not the PBC that killed her. We did not get a post mortem done to confirm this so will never really know for sure. All I know for sure is that her death certificate said she had multiple organ failure.

Just remember that research, drugs and awareness of the condition has come a long way in the last 20 years so please stay positive. Let us know how you get on. x

[LindaRose]

The liver can only regenerate if it it not scarred. PBC scars the liver through destruction of the tiny bile bile ducts. After transplant the PBC may but not in every case return, ( but more likely than not) I am nearly 9 years transplanted and my liver is in great shape despite still having PBC. I am not on URSO yet, but will see if my bloods improve with it before my next clinic appt. I lead a a very full life thanks to my transplant.

[busylady in reply to LindaRose]

Thanks Jtxx and LindaRose for your response,

I will let you know how I get on. I think they may still decide its too early to put me on the list but my Consultant has referred me back to the transplant centre as my biliribin levels going up.

I do manage to stay positive most of the time, we all have blips though dont we..........I guess we all want answers, and this disease is a tricky little blighter so its not always straightforward to get an answer is it !!

Thats sad about your Mum Jtxx, but her quality of life was good and thats important isnt it................LindaRose, your an inspiration to me..........there is hope

Thanks for taking the time to reply

x

[Saundrella in reply to LindaRose]

Linda Rose You ARE good news!! Thanks for sharing....

[LindaRose]

If you need any more support - just let me know - where are you under?

[busylady]

I am at the Hallamshire (sheffield) for the routine/Hepatology, but have to go to St James in Leeds for transplant assessment etc.

Thanks LindaRose

x

[June9961]

Hi my little sister had a liver transplant and lived a good life for 15 years. She did have PBC after the transplant but did not suffer the horrendous itching she had the first time round. She died last April of cancer which was not related to the PBC but it was related to an error by the hospital who lost notes showing that she had a growth in her kdiney during a routine anti rejection drugs screening.