1. Chronic Liver Disease & Symptoms of Liver Failure A Liver Transplant patient’s perspective Bethli Wainwright 12th August 2002

2. Agenda Liver failure, aged 8 in 1974 Post diagnosis treatment, including splenectomy and admittance to hospital in March 2000 with liver failure. March 2000 - August 2000: needing a liver transplant but basically inoperable. Iloprost treatment. August 2000 transplant, and immediately afterwards. Recuperation and back to full-time work. Question and Answer session (15 minutes, run by Dr. Mike Eade).

3. Taranaki Base Hospital (left) and Hawera Hospital (below) with jaundice, ascites and no diagnosis October / November 1974

4. Kayser-Fleischer rings drawn after de-coppering started. 1 year later (above) and nearly two years later (right) Exploratory laparotomy, which showed severely cirrhosed liver.

5. Splenectomy, January 1987 When the spleen was removed, it measured 15 inches by 9 inches by 7 inches, and the cut went from the lower right of the abdomen to the upper left around under the left arm and onto the back. The surgeon was Prof. James Shaw. He shunted the splenic vein to the left renal vein. The fact that he didn't cut it short, as was the usual practice, meant that the New Zealand Liver Transplant Unit 13 years later could attach the donor liver portal vein to it. Side view of splenectomy scar including two drains which scarred.

6. Sick again Photo taken in February 2000, 1 month before urgent admittance to 7B, the Liver Unit. Symptoms Weight gain (I thought from sedentary lifestyle) Legs leaking fluid (I thought from scratching as they were always itchy, and I was flying a lot so expected oedema to be worse) Ear leaking bright yellow gunk constantly (GP trying to fix this from November 1999 to March 2000 with no luck - infection from Adult Learn to Swim classes) Extremely difficult to breathe when moving at all (I thought from being unfit) Tired (unfit, and working from 8:30 am to 10 pm Monday to Friday, and 4 hours Saturdays and had just been studying at Post-Grad level p/t for past two years) Jaundiced (didn’t notice this)

7. LISTED FOR TRANSPLANT!! (Above) Prof. Munn (one of my the two surgeons doing the transplant), and me, the morning of the transplant. (Right) Recovering one week after the transplant, back in 7B, and hardly any tubes left. (Note, heart no longer hurting but not aware of the pain until it disappeared).

8. 33 year old cirrhosed liver (with gallbladder) Livers, old & new Not me, but I would have looked like this, as this photo was taken in New Zealand.

9. Scars & other stuff (Above) 2 months post-transplant and still looking impressive. (Right) 2 years post- transplant, and can barely be seen.