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Ask The Expert Archive

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Transplant Center Archive Questions

Below are Dr. Barth’s answers to Transplant Center questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Questions about this topic have been organized into several categories.
Click on a category name below or select "View All" to read all the Q&As in this archive.

. Kidney Transplant
. Liver Transplant
. Pancreas Transplant
. View all Questions
. All Questions

Now displaying records 1 to 15 of 101.

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Q : 1

Can a person with Gilbert Syndrome be a living liver donor?

There may be no specific contra-indication if all other work-up is normal. Extensive work-up and medical evaluation are necessary and would need to be without additional findings. You can contact our center at 410-328-3444 for additional information.

Q : 2

What is the most common indication of liver transplantation?

It depends on the country and center. Hepatitis C and alcohol are the most common at our center.

Q : 3

What are the variables leading to a score that determines readiness for a liver transplant?

You need three blood tests called bilirubin, INR, and creatine that are used to calculate what's called the MELD score. This gives an idea of how advanced your liver disease is. If your score is less than 15 and you have no real problems such as bleeding, ascites or confusion, then most centers would wait until the score gets higher before listing. Most centers are transplanting patients with MELD scores of 25 or higher.

Q : 4

Can you transplant a metastasized liver?

Only neuroendocrine cancers that are found only in the liver and that have been stable there for a long time. Otherwise, no.

Q : 5

What is the prognosis of a liver transplant patient?

The prognoses are 85-90 percent one-year survival and about 70-75 percent five-year survival.

Q : 6

Do you perform partial nephrectomies at your facility?

Yes, we do and we do it laparoscopically (robotically).

Q : 7

I am a liver transplant patient. Is it safe to remove an enlarged spleen? I always have a low CBC and anemia.

We prefer selective embolization, which is done by intervention radiologists. We have had good success with selective splenic artery embolization and have avoided large and potentially dangerous operations in several patients.

Q : 8

I had a liver transplant five years ago. A recent MRI noted fibrosis and small ascites in the pelvic region. What are the risks? Will I have to have surgery again?

You should get a biopsy of your liver and check with your liver transplant team.

Q : 9

Do you or another doctor at UMMC use Hepatic Arterial Infusion?

For cancer, yes. Dr. Richard Alexander and myself install the pumps.

Q : 10

How do you get on the liver transplant list and how long do you have to be sober to get on the Maryland liver transplant list?

The general rule is six months, but there are exceptions. You can be evaluated at any time.

Q : 11

Can a mom with B+ blood donate to daughter with O+ blood?

No. The blood types have to be compatible, such as the reverse, O to anything, B to B, A to A, or anything to AB.

Q : 12

Can you explain what happens to the newly implanted organ in terms of the body fighting the transplant and the organ adapting to the new body?

Your immune system is always going to try to fight what is "foreign" so drugs are necessary forever. Having said that, there is some adaptation that occurs, so fewer medications or lower doses may be acceptable. However, we have not reached the point where the body is totally tricked and tolerant to the organ.

Q : 13

What is the success rate for a pancreas transplant?

Pancreas transplants alone have a 85-90 percent chance of surviving one year post transplant.

Q : 14

If a dialysis patient had to have their kidney removed because of suspected cancer and a very small trace was found, but they do not require any treatment, how long do they have to wait before being added to the transplant list again?

Sometimes they can be added back to the list immediately. A final decision is based on the pathology.

Q : 15

How long do patients usually have to wait for a pancreas transplant?

For just a pancreas transplant, the wait time is short. If you need a combined kidney and pancreas transplant, the wait can be up to 2 years depending on your blood type. Typically, it's under a year.

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