Vilasrao still critical; no liver transplant

Chennai/Mumbai: Union science and technology minister Vilasrao Deshmukh, admitted to a Chennai hospital on Monday, remained in critical condition on Tuesday. Deshmukh is conscious but has been on life-support in the intensive care unit. 

    Doctors at Chennai's Global Hospitals are treating the 67-year-old minister for hepatocellular carcinoma, a form 
of liver cancer, which has led to multiple organ failure. Deshmukh was diagnosed with liver failure over a year ago. 
    The doctors said they could not plan a liver transplant as Deshmukh's condition had to stabilize first. "He is on ventilator support and was given dialysis," a doctor said, adding, "However, his condition has not deteriorated since his admission." 'Severe blood infection damaging other organs' 
Docs Wait For Deshmukh To Recover From Infection, Defer Transplant 
Chennai/Mumbai: Union science and technology minister Vilasrao Deshmukh's son Amit, informed Maharashtra chief minister Prithviraj Chavan on Tuesday that his father's condition was slightly better than on Monday. 
    "Amit spoke to Chavan and briefed him on his father's health. He expressed concern, but was optimistic of an improvement in a day or two," a senior government official told TOI on Tuesday. A family member also said the ailing former chief minister's response to treatment was lukewarm but expected some improvement soon. "If there is marked improvement in the basic parameters, only then will a decision be taken on whether to go in for the liver transplant. We expect it will take a minimum two to three days to arrive at any conclusion," he said. Deshmukh was admitted to Mumbai's Breach Candy Hospital a week ago and was diagnosed with both liver and kidney failure. He was flown to Chennai for a liver transplant by air ambulance on Monday. 
    Some reports had said Amit, who is also a Congress legislator, urged Chavan and deputy chief minister Ajit Pawar, who were planning to call on Deshmukh on Tuesday, to postpone their plans. However, the official said neither Chavan nor Pawar had any immediate plans to visit Chennai. 
    Entry to the ICU has been restricted to prevent infection, doctors said. A spokesperson told reporters that the hospital could not reveal details as the minister's family had requested privacy. "We respect patient privacy," he said. 
    When Deshmukh was flown to Chennai, doctors initially thought they should convince one of his blood relatives to donate a part of his liver, or put him on the waitlist for a cadaver transplant. However, when they found he was suffering not only from kidney failure but a severe bacterial blood infection as well, they concluded a transplant was not the immediate option and decided to wait till his condition stabilized first. "In the ICU, we give each of the vital organs (heart, brain, lung, kidney and liver) 20 points. If three of his organs aren't stable, the patient loses 60 points. That is why his condition is considered critical," said a doctor in the ICU. "But the minister is alert and conscious, indicating good brain function. His heart is also pumping normally." 
    The pressing concern is the blood bacterial infection, which is causing serious damage to his organs. "Our first priority is to bring the infection under control or it could damage healthy organs and his condition could deteriorate further," a doctor said. "We have given him some antibiotics as he has a blood infection. We don't know what exactly the infection is but samples have been sent for tests and will arrive late on Wednesday," the doctor said. 
    Deshmukh has been administered broad spectrum antibiotics that will cover his bacterial infection, but doctors will make the treatment more specific after receiving results of blood tests. Once the blood infection has been treated, Deshmukh will slowly be taken off life support, including ventilator and dialysis. "It's too early to discuss a transplant. But that could be an option if he responds to treatment for the blood infection," said a liver transplant surgeon from Mumbai. But he said doctors may have to use radiation therapy to shrink the size of the cancerous tumour. "He has a very large tumour that cannot be removed easily," he added. 
    Deshmukh's doctor, transplant surgeon Dr Mohamed Rela, could not be contacted. The minister's family, including wife Vaishali, actorson Riteish and daughter-inlaw Genelia were at the hospital. Union minister of state for coal Pratik Patil visited the hospital in the evening and was briefed about Deshmukh's health. 
LONG FIGHT AHEAD Liver Cirrhosis 
Cirrhosis, or 
scarring of the liver, results in poor liver function and causes chronic liver disease 
Triggers 
Hepatitis C, longterm alcohol abuse, inflammation of liver, disorders in the drainage system of liver, medications, metabolic disorders 
Warning signs 
Confusion, impotence, loss of interest in sex, breast development in men, loss of appetite, nausea, vomiting, nose bleeds, clay-coloured stool, spider-like blood vessels on the skin, edema, vomiting blood or blood in stools, weakness, clotting problems, weight loss and jaundice 
Management 
Patients are screened every six months. Doctors recommend a CT and MRI of the abdomen, ultrasound and liver function test 
What Ails The Former Chief Minister 
The 67-year-old minister is being treated for hepatocellular carcinoma, a form of liver cancer that has led to multiple organ failure. Liver cancer is usually caused by cirrhosis 
Vilasrao Deshmukh's Treatment 
While hepatocellular carcinoma is mostly fatal, the first step of treatment is a liver transplant. However, since 
Deshmukh has kidney failure and a severe blood bacterial infection, which is affecting all his other organs, doctors have ruled out liver transplant for now. It could be an option only if he responds to treatment for the blood infection. Till then, radiation therapy may be used to shrink the cancerous tumour as it is too large to be removed easily by surgery 
    Vayalar Ravi in charge of SME portfolio 
    Overseas Indian affairs minister Vayalar Ravi has been given additional charge of the micro, small and medium enterprises ministry. Vilasrao Deshmukh, the science and technology minister, had assumed additional charge of the ministry after Virbhadra Singh resigned when a Himachal Pradesh court framed corruption charges against him in June. The decision to give additional charge of the ministry to Ravi came after the condition of Deshmukh, who is admitted to a Chennai hospital for a liver-related ailment, turned "critical". agencies

Only if there is marked improvement in (Vilasrao Deshmukh's) basic parameters, will a decision be taken on whether to go in for the liver transplant. We expect it will take a minimum of two to three days to arrive at any conclusion 
—A family member