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LETTERS: Roger Williams Role of living liver donation: Requirement for transplantation is high BMJ 2003; 327: 1287-b [Full text]

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Cirrhosis of the liver; need of the liver transplant could be minimized judiciously

Dr.Hanamaraddi.T Gangal, 580021. Karnataka. India   (29 November 2003)

Cirrhosis of the liver; need of the liver transplant could be minimized judiciously 29 November 2003
Dr.Hanamaraddi.T Gangal, consulting and practicing surgeon P.B.Road & 3rd Cross Hosur. HUBLI, 580021. Karnataka. India Send response to journal: Re: Cirrhosis of the liver; need of the liver transplant could be minimized judiciously	Cirrhosis of the liver is a common condition, forming a major part of the liver diseases needing to be treated. It manifests in any age, commonly in males in the form of 1 Raised portal pressure with episodes of bleeding and to be fallowed by its consequences like anemia, enhanced atrophy of the liver, finally liver failure 2. Manifest as ascitis, later leading to intractable ascitis, liver failure These patients are treated variously world over with no appreciable benefits leading now to promote liver transplantation. In view of the present trend of thinking that the basic major cause for most of the diseases is disturbed metabolism and accompanied disturbed hormonal regulation. This is yet to be defined in a full and understandable manner, so as to be utilized for application in clinical use. It needs to be appreciated the organ failures are a gradual process in majority of the cases, and on occasions are acute as in MOFS. We need to appreciate metabolism plays major role in the nourishment of the organs and their well being and to avoid their disturbed function. Hence the author has all along is of the view that all patients under stress and disease do behave like diabetic and are insulin dependent. Accordingly he has postulated the concept and the formulations to rejuvenate the organs by their use as and when need arise. He has also developed a safety valve shunt operation (1970 -72) to meet the operative need if it arises, to be supplemented with the concept of use of Insulin and Dextrose as a concept and the formulations to rejuvenate organs. All this has yielded fairly acceptable results. However these procedures at present are of major magnitude, carry high morbidity and mortality, as is noted with any other equivalent procedures undertaken for the purpose. In case the patients withstand the operative procedure, they carry good chance of recovery. These results appear to be acceptable in the present circumstance as against the high morbidity and mortality associated with the variety of other forms of procedures. This procedure can be improved to make it safer and to reduce the operative trauma by developing devices. All this may minimize / avoid the need of liver transplant. The Author was associated with development of open-heart surgery, parasitic organ transplant, and homologous organs perfusion for organ failures supported by ICMR. He was Hon Prof of Surgery at a Government Medical College Hubli. Post Doctoral Fellow in Cardiovascular Surgery at Baylor College of Medicine, Houston TX USA. Member of the research Committee Rajiv Gandhi University of Health Science Karnataka Bangalore. References. 1. Meso-caval Anastomoses (Ilio – mesenteric) Journal of Mysore Medical Association Oct – Dec 1973. 2. Meso-caval Anastomoses (Ilio – mesenteric) in Portal Hypertension. Indian Journal of Surgery. June 1977. 3. Meso-caval Anastomoses (Ilio – mesenteric) in Portal Hypertension. Reviewed by Selby Roy, Chicago. Clips and Quotes. International Surgery May – June 1978. Competing interests: None declared