Blood urea nitrogen (BUN 14 mg/dL Creatinine: 1.0 mg/dL Sodium: 129 mmol/L (low) Potassium: 4.2 mmol/L. Total bilirubin: 2.8 mg/dL (high) Direct bilirubin: 1.0 mg/dL (high) Protein: 6.2 g/dL. Albumin: 2.4 g/dL (low) Calcium: 8.0 mg/dL (low) Aspartate aminotransferase (AST 115 U/L (high) Lactate dehydrogenase (LDH 254 U/L (high) Alkaline phosphatase (ALK 156 U/L (high) Alanine aminotransferase (ALT 45 U/L Gamma-glutamyl transpeptidase (GGT 88 U/L. Speaker 2 : I agree. Clearly, this patient has refused to have a biopsy, and that is much less involved than a transplant. I would be concerned that the patient's degree of motivation has to be taken into account. The discussion was based on individual clinical expertise and limited published e case is adapted from one presented at the VA Advanced Liver Disease Resource Training Program, held in San Francisco in June 2006. Discussion Question 1: This patient is extremely motivated to start treatment, but the literature states that treatment is not recommended in individuals with decompensated liver disease. Are there any options for this patient in regard to treatment outside the research arena? He has a total bilirubin of 2.8, and an albumin of 2.4. So, you look at the Child-Pugh score for this patient. He apparently does not have encephalopathy, so that is 1 point.

Case study for cancer patient