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Should a transplant waiting list patient have an endoscopy?
Hi, and thanks for being here! I'm a 48 y/o female, have had HCV for 27 years (one of those with normal ALT/AST the whole time) genotype 3a who's been on a waiting list for a liver since 1997. I have huge hilar, gastric, esophageal and coronary varices visible on CT scan, my spleen is 20cm, and my portal vein is enormous. I'm currently on PegIntron in an effort to eradicate the virus before transplant, and on Propanalol to keep my BP/pulse down. So far my cirrhosis is compensated; I've had no bleeds. I'm having some gastric discomfort on palpation and my doc recommends an endoscope to check for gastric ulcers/h. pylori and to evaluate the varices.
What are the risks of this procedure compared to the benefits? We know the varices are there, I can get a blood test for h.pylori, and my family is concerned about the risk of perforation and causing a bleed.
Dr. Chung writes--
Yes you can get a blood test for h. pylori. I would recommend hepatic venous pressure gradient testing to determine if your portal venous pressure has dropped to an adequate level, one that is at low risk for bleeding. RC
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