I have been going to the hospital this but still on tenofovir df. They ran a lot of some tests again and ultrasound.
After seeing the results and the symptoms I’m presenting, she said the only solution now is liver transplant which is only done abroad and very expensive. But they need to place on more drugs and run some more tests. It was a big blow. I felt cheated and conspired against by these issues. I don’t have words for this feeling.
I’m really sorry to hear about this, @Johnpaul_Ezeike. While I can’t appreciate what you’re going through at the moment, I hope you have some support around you to help you through this tough time.
I am not qualified to tell you if you need a liver transplant or not, you would need to discuss this with your liver doctor. There are many causes of hypoechoic masses, so there would need to be some sort of confirmation of what these are.
The doctor has said that is the only medical option left for me after a series of tests this few weeks. It’s to be done abroad and very expensive that I can’t even afford it. I don’t know what to say again.
Hi John,I am so sorry for that report from your Dr,I don’t argue with that, but I am sure there is a way
Don’t loose hopes because there is always a way for any challenge in this life.
What I am telling you, you should try your best to be very positive with the situation,trust in God and have good health habits.
Try as possible as you can to get rid of stresses because from my own experiences, stresses is the major trigger of health worsening.
It’s been a week since I advised you to seek a second opinion. Have you been able to do that?
If you’re having troubles getting access to one, I can give you contact to some specialist if your location is Nigeria.
Hi John Paul
Remember I have done hepatectomy and my surgeon (the only liver surgeon in Kenya Dr Karan Gadhi) is competent to do liver transplant.The challenge probably can be cost.My surgery was @kes 2.3M can help you get in touch with him.He has been too good to me.
I am glad to hear that you had your surgery. I don’t remember seeing an update. I am sure you are still recovering but it would be nice to read more about your whole experience with the surgery and what the outcome is so far. I am curious about your procedure and have a few questions:
-How much of your liver was resected?
-Did you have to have radiation therapy or chemotherapy before the procedure?
-Do you know if the procedure was done using laparotomy or laparoscopic surgery?
-How long ago was the procedure and how long were you in ICU before you got to go home?
-How painful has recovery been?
I hope you heal well and look forward to hearing more. I read that it can take up to 3 months for full recovery, so don’t feel you need to respond to all these questions until you feel well enough.
My last question is for the @scienceexperts and @healthexperts because my curiosity has gotten the best of me. The scenario would be basically what Kinoti has gone through. The patient has CHB and HCC. Let’s say hypothetically that 60% of the liver was resected. I read that the liver CAN heal or regenerate 2/3’s of its volume within a few weeks but can take up to several months. Let’s say that it has been as long as necessary for the liver to regenerate fully. Does the 40% of the liver that still had HBV, replicate that to the rest of the regenerated portion of the liver or does having more than half a healthy liver help eradicate the smaller infected portion. This patient was on antivirals prior and currently. Will being on antivirals help keep the lesser portion of the liver from infecting the larger regenerated portion?
From a basic science perspective, it would be likely that the regenerating liver would be re-infected by virus in the blood that continues to be made by the remaining infected cells. That would be suppressed in 2 ways: 1) Effective nucleoside analog therapy can suppress infectious virus in the blood to nearly (but not completely) zero. Second, reinfection would be affected by the efficacy of the person’s immune system. If sufficient cytotoxic T cells were around and/or if enough anti-HBs antibodies were being made (or provided by HBIG treatment), reinfection would be further slowed. These variables would be different for each person, and I don’t know how they work out in real-life clinical practice.
Thank you for your quick response. I think I was hoping that it was possible that the antivirals would keep the infected portion of the liver at bay and that the new majority portion would stay cleared and because the majority of the liver was good, that it could possibly fight against the infected portion and heal it. It was just a little hope because I can see the better chance that as the resected portion starts growing that HBV would spread to it as it grows.
I wonder if there would be any difference if, instead of the resected portion slowly growing and being infected as it grows, what would happen if instead it was actually replaced with a donated good portion of liver. Would that make any difference because the good portion is more instantaneous versus the slow regrowth from an already bad liver.
Thanks again for your response and your scientific expertise.
The situation with a transplanted liver is similar to a resected liver, but without the reservoir of infected cells that continue to produce virus. Without antiviral interventions, the new liver is infected about 100% of the time. With pre- and post-therapy nucleoside analog treatment plus relatively long-term HBIG, reinfection can be stopped the majority of the time. I cannot remember the statistics offhand, but re-infection can often be stopped in this case with careful medical care.