Wow...moving forward every day!

Thanks for posting. Very encouraging for those who have people who love them so much they would risk their own lives to help them.

Hoping there will be other solutions soon for those not that lucky.

LDLT or Living donor Liver Transplant has been around since the late nineties and has similar outcomes for the recipients as the deceased donor liver transplants do when it comes to survivability in one and five year percentage outcomes...

However, there's never enough mentioned regarding the living donor's post transplant outcomes which do not paint such a rosy picture for this procedure if it were to be used more frequently and without the unique awareness required when monitoring both the recipient as well as the donor post transplant..

This study emphasizes the need to use this procedure in a very limited manner and without rushing to find appropriate donors as well as considering the donors potential for survivability after the transplant...

It lists the many potential problems that may become a reality if not carefully considered when using the procedure as an alternative to deceased donor transplants... Especially for patients suffering from ALF(Acute Liver Failure) and used to be called Fulminant hepatitis which doesn't leave the surgeons much time to find the right match for the patients from the deceased donor supply available.

Still, it does offer transplant programs an alternative source of organs which were not even considered until this procedure was first used in pediatric transplants over 10+ years ago and that's always positive IMHO... This is from the article that I consider important to the overall message resulting from these studies in Japan...

Our study demonstrates the benefit of LDLT in a Japanese population, which has less access to deceased donor organs, concludes Dr. Sugawara. Prospective studies are needed to determine the overall impact of LDLT in all patients with ALF.

In a related editorial also published in Liver Transplantation, Professor Chung-Mau Lo with the University of Hong Kong and Queen Mary Hospital in Hong Kong, China, notes that LDLT for ALF patients has generated debate among experts in several areas:

(1) reports in Western countries of inferior outcome with LDLT in high-urgency situations;

(2) likelihood of ALF patients receiving a liver in countries with developed deceased organ donation programs; and

(3) concern with coercion of donors and a possible increase of donor risk when the evaluation process is rushed in such an urgent situation.

Deceased donor liver transplantation is dictated by the availability of the organ, and high-risk marginal grafts are frequently used. LDLT allows for early transplant to avoid waitlist mortality and better timing of the operation, which can be performed at the first sign of patient deterioration, concludes Professor Lo:

LDLT for ALF has developed in Asia because there is no choice. Is it possible that it may in fact be a better choice?

It could be a better choice but, that all depends on the donors overall health, the time available for the recipient to wait until the patient's overall condition starts to deteriorate, and whether or not one has someone unselfish enough to volunteer part of their own liver that has to be a match tissue type wise.

Generally speaking, LDLT's are better suited in pediatric patients although there have been better procedural improvements that have increased the survivability of both the patient as well as the donor who is only recently considered to be more carefully monitored post transplant and therefore, increasing successful outcomes...

There was a period of about two or three years where many liver transplant centers that featured LDLT's were forced to either completely shut down or suspend their programs because of the poor outcomes that resulted from total lack of consideration for the well-being of the living donors and the recipients long term health monitoring... Nowadays better outcomes are a direct result of the improvements made to these programs.

Respectfully,
Henry

Thank you for adding this information on the subject. As more of us move into stage 4 and as some of us cease to have compensating cirrhosis, the more the conversation needs to increase about transplant.

Something went crazy when I tried to post earlier...

I agree completely.
I have got so many articles I saved over the years so I'll post them up as soon as I find them.

Respectfully,
Henry

I just started looking through some of my links and, I gotta say that some of these video's aren't for the fainthearted so beware:

This first one is a bloodless liver resection:

http://www.youtube.com/watch?feature=fvwpbe&NR=1&v=9Ae3H4ZFCaA

This one is a living donor liver transplant done @ Kyoto University in Japan:

http://www.youtube.com/watch?v=ZD_Tlu1JUoI&feature=related

Here's a ultrasound assisted liver biopsy being performed by Dr. Galati's team... Marylyn knows who he is:

http://www.youtube.com/watch?v=ug3n7bvq2Wg&feature=related

Another set of liver transplant videos from Japan:

http://www.youtube.com/watch?v=tEaFlcXv7uQ&feature=related

http://www.youtube.com/watch?v=v43hWn_sCWo&feature=channel&list=UL

Finally, this one is very interesting and educational for both you and Marylyn as well as anyone else who yearns to learn more.

I'll post some more but, right now I'm gonna concentrate on the LSU - Washington college football game.. Enjoy!

Respectfully,
Henry

Thank you Henry although I think I will refrain from viewing at this point. I am not particularly faint of heart but I am in fear of what the future may hold.
Dialogue and hopeful new treatment breakthroughs are where I will focus for now.
I did visit some Cirrhosis support sites in the past and they knocked the wind out of me.
Seeing people like you and MLTTexas inspire me!
Thank you again! :)

Understood...

How about this video which talks about INX-189 made by a company educational collaboration in the UK called Inhibitex & the Welsh School of Pharmacy:

http://www.youtube.com/watch?v=R4Za8OZWfHY&feature=related

If I find more relevant information I'll post ASAP.

Respectfully,
Henry

Here's one I know you'll find interesting:

http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM225333.pdf

Look @ page 22 in the .pdf

We can all start bugging the crap out of the FDA now that we have the addresses & phone #'s and e-mail addy's so we can get them to move as quickly as they could!!! the more we pester them the more likely they'll do something just so they could get us off of their heads!!! Here we go!!! Round 1 with the FDA!!!

Now I'm Psyched!!!

Respectfully,
Henry

I almost forgot...
Here's the contact information for the FDA:

Office of Communications, Division of Drug Information
Center for Drug Evaluation and Research
Food and Drug Administration
10903 New Hampshire Ave., Bldg. 51, rm. 2201
Silver Spring, MD 20993-0002
Tel: 301-796-3400; Fax: 301-847-8714; E-mail: druginfo@fda.hhs.gov
http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/default.htm

Respectfully,
Henry

Here's another article:

http://www.hivandhepatitis.com/hepatitis-c/hepatitis-c-topics/hcv-treatment/3654-promising-proof-of-concept-data-for-hepatitis-c-ns5a-inhibitor-ppi-668

Now I don't know if this is of interest but, you may want to at least check this study out:

http://www.clinicaltrials.gov/ct2/show/study/NCT01509391?term=hepatitis+C&rank=35

Henry

Thank you Henry
I've been keeping an eye on trials at HCVAdvocate Drug Pipeline
http://www.hcvadvocate.org/hepatitis/hepC/HCVDrugs.html
and I think it's great to share them on DS!