The Candidate with Hidden Cirrhosis

This flow follows a seemingly suitable transplant candidate whose silent liver fibrosis changes the entire treatment pathway.

increasingBearing stren­gth in each eventdecreasing

Apparently Stable Candidate

Apparently Stable Candidate Few visible signs The candidate may have normal or modestly abnormal liver enzymes, no ascites, and no encephalopathy. Dialysis-related biochemical patterns can conceal the severity of HCV injury. The danger of reassurance Clinical stability does not exclude advanced fibrosis. Screening must therefore proceed even when the patient appears ready for kidney-only transplantation.

Biopsy Revelation

Biopsy Revelation Staging the invisible Liver biopsy reveals whether the candidate has minimal fibrosis, bridging fibrosis, or Cirrhosis. The result changes both prognosis and eligibility. A decision with consequences The biopsy may justify antiviral treatment, continued listing, kidney-alone transplantation, or referral for combined transplantation. A quiet patient becomes a high-stakes allocation case.

Changed Destination

Changed Destination Kidney alone is withdrawn Established or decompensated cirrhosis creates excessive surgical and posttransplant risk. The candidate’s path turns toward liver-kidney assessment. The human cost This transition can mean a longer wait and a more complex operation. It demonstrates how a disease discovered through kidney care can ultimately determine access to both organs.

during initial transplant evaluation

after persistent HCV RNA detection

when decompensation or portal hypertension appears