Hello PSC Group. I want to send this question out to the group for opinions. This question was posed on another board I am on. I would appreciate your feedback.
Mark
"My 15 year old has asymptomatic WPW. The cardiologist and electrophysiologist at a world class pediatric hospital have recommended a cardiac cath procedure to stratify his risk and to possibly do an intervention procedure at the same time if it is determined that he needs it. I read that 1% of patients end up needing a pacemaker due to injury / complications from the risk assessment procedure. My son's tachycardia seems to be bothering him more and more... He wants the procedure because he is uncomfortable with the way his heart feels. The doctor doesn't seem to think he's in immediate danger, but I brought up concern that as his PSC progresses the risk could increase, and the electrophysiologist agreed that it might be better to do it now while he is still in the early stages of his PSC. There is only a small chance he would end up with a pacemaker, but I am wondering if that DID happen, if a pacemaker would disqualify him for being a cadaver liver recipient."
I personally don't think a pacemaker will make you ineligible for a transplant. My understanding of liver transplant is that the conditions for the eligibility of liver transplant is quite simple in principle: there has to be sufficient benefits for a transplant. If the pt can't survive the transplant surgery (risk too high - severe other medical conditions) or the pt may not live long enough due to other medical conditions (metastatic ca, etc) or the transplanted organ will be likely wasted due to certain conditions (alcoholic pt), then the pt will be deemed ineligible. I don't think a pacemaker falls into any of those categories.
I did ask my hepatologist about it and he has the same opinion. But it's unofficial since I'm not the pt here. Each pt has to be evaluated individually. We're just chatting.
On the other hand, depending what type of WPW, it could kill a pt at any moment and within seconds under the right condition (Vtach). But for PSC, it at least will take months. So if needed, why hesitate about a trip to cath lab? And , how can it still be called "asymptomatic" WPW? That kid had tachycardia.