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Bishop of Athens to Undergo Liver Transplant

July 25, 2007

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Millions of people worldwide are affected with hepatitis infections and, as people who are familiar with hepatitis know, the disease can affect anyone. After recovering from his intestinal cancer operation, it has been recommended to Orthodox Archbishop Christodoulos of Athens that he undergo a liver transplant because of his end-stage liver disease, chronic hepatitis and cirrhosis. Learn more about the liver transplant set to take place, as well as what the risks are for the surgery.

Bishop of Athens to undergo treatment in Miami

Orthodox Archbishop Christolodoulos of Athens will undergo a treatment for end-stage liver disease. Dr. Andreas Tzakis of the University of Miami medical school will perform surgery on August 15.

www.speroforum.com
by George Gilson
Friday, July 20, 2007

Greek-American liver transplant expert Andreas Tzakis announced that Archbishop Christodoulos has agreed to undergo a liver transplant to try to cure his end-stage liver disease, which includes a four-centimetre malignant cancer, chronic hepatitis and cirrhosis.

Tzakis, flanked by Christodoulos’ attending doctors at Athens’ Aretaieion hospital, told a July 12 news conference that Christodoulos will be taken to the University of Miami’s Miller School of Medicine after August 15.

He said the archbishop’s medical team, including surgeon Dionysios Voros who operated on Christodoulos’ intestinal cancer on July 13, unanimously agreed that a transplant should be undertaken “as soon as possible”, and specifically in the next six weeks, after full recovery from the intestinal cancer operation. Voros said that Christodoulos was informed after he entered hospital on June 9 that he would likely undergo a liver operation.

After pre-operative screening in August, the archbishop will be placed on an organ waiting list. Tzakis said that Christodoulos scores a high 22 points on the Model for End-Stage Liver Disease (MELD) scoring system, placing him at the top of the list.

Aretaieion doctors said that Christodoulos is now off all intravenous medication, walks about the hospital and could be released within days.

Tzakis said that the decision to expedite the transplant is intended to minimise the risk of metastasis to other parts of the body. He maintained that the large size of the archbishop’s tumour will put him at the top of the organ waiting list in the United States. He admitted that in Europe patients with such large liver tumours, and with two types of cancer, are not considered candidates for transplantation.

Asked by the Athens News what the risks are for the surgery given the 68-year-old Christodoulos clinical profile, which includes two types of cancer and diabetes, Tzakis appeared exceedingly optimistic about the prospects of success. He said that the intestinal cancer was successfully treated by removing a large portion of the intestine, though he admitted there are “no guarantees” that there cannot be a recurrence, and stressed that Christodoulos’ liver is “at a point where it is ready to lose its balance”.

“The hepatitis is not active, and of the two cancers one was removed. Now he has cirrhosis and diabetes, which may be connected with the liver diseases and is being treated with insulin,” Tzakis told this newspaper.

But he conceded that the diabetes “burdens the clinical profile somewhat” and requires extremely comprehensive clinical screenings of the heart, kidney and other organs. The screening process, which will begin in Athens, will also seek to make certain that the intestinal and liver cancer (which the Aretaieion team said was not a metastasis) has not spread to other parts of the body.

Tzakis noted that German transplant surgeon Christoph Broelsch, who pioneered liver transplants at the University of Chicago in the mid 1980s and examined Christodoulos on July 4, also recommended a transplant after preparation.

As for Christodoulos’ age, Tzakis said it is not a counter-indication for a transplant and noted that an octogenarian liver transplant patient of his is now over 90 years old and is doing well.

Stressing that pre-operative condition is the key measure of transplant success, Tzakis said the post-transplant prognosis for Christodoulos is good, as he was extremely active and fit until now. “His heart and kidney function are totally normal. If he had full mental and physical capacities before, with all these illnesses, after a transplant you’ll see him better than he has been for years,” he said.

The Greek-American surgeon also ruled out various types of chemotherapy that were previously discussed as options – such as chemoembolism, which targets large doses of chemotherapy directly at the liver – as these “could burden the function of the liver and the body overall”.

Tzakis conceded that the lifelong immunosuppressive drugs required by liver transplant patients could conceivably lead to a recurrence of intestinal cancer, but only if some of the intestinal cancer tumour has remained in the body. Thus, he indicated that the risk-benefit analysis clearly favours a transplant. He said immediate recovery (walking etc) would take weeks, while full recovery is a matter of months and continues gradually. “Longterm recovery is clinically complete,” he said.

George Gilson is a writer for the Athens News, Greece.

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