Cirrhosis of the Liver: Megan McGillin was diagnosed at age 10

A medical student who was diagnosed with an alcoholic's liver at the age of 10 said rowing had delayed his need for a liver transplant.

Megan McGillin, from Northern Ireland, was diagnosed with cirrhosis, or scarring of the liver, 11 years ago, which means her liver no longer functions properly.

Liver disease in children is rare.

The hepatologist said maintaining good health “plays an important role in keeping the liver in a stable state.”

Cirrhosis cannot be cured or reversed, and many of the liver disorders that cause cirrhosis in children cannot be prevented.

In the case of the County Down woman, doctors don't know how she contracted the disease but say the damage will eventually be so extensive that it could cause her liver to stop functioning, leading to liver failure.

“[Doctors] “When I was first diagnosed, doctors told me I would likely have a transplant at 18, but I remained healthy,” Megan says.

“Then when I was 16 or 17, doctors told me I would definitely need a transplant by the time I was 21.

“When I turned 21 in November, I didn’t have my transplant on my birthday.

“I just kept working my way through it, and now they've taken the whole timeline away.”

Liver diseases such as cirrhosis can also cause portal hypertension, which can lead to an enlarged spleen.

For Megan, this meant having to give up contact sports, which were “a big thing” for her.

She then developed an interest in rowing and rowed for the Irish High Performance team for several years whilst at school.

The Bangor woman said the sport has helped her stay healthy, saying: “It was a struggle but I always trained and looked after myself from the inside out and I think this high intensity sport has kept me healthy over the years.”

She believes that staying healthy has allowed her liver to continue functioning for so long.

Dr Girish Gupte, a consultant paediatric hepatologist at Birmingham Women's and Children's Hospital, runs outreach clinics six times a year at the Royal Belfast Children's Hospital.

“Because liver disease in children is so rare, the majority of the population may never have heard of a child having chronic liver disease,” he said.

“The incidence of liver disease in the UK population ranges from one in 10,000 to one in a million for other liver diseases.”

Dr Gupte said cases of chronic liver disease have been increasing in recent decades, largely due to advances in testing technology, but he believes environmental factors and lifestyle choices also play a role in the rise in liver disease among children.

“Not every child with liver disease will need a liver transplant,” he says.

“Most of these conditions can be managed with proper treatment and a healthy lifestyle,” he added.

“But in some children, the liver disease progresses to end-stage liver disease, and these children will require a liver transplant while they are still children, or perhaps as adults,” he said.

“I think staying healthy, eating a healthy diet and preventing fat buildup in the liver through a healthy diet plays an important role in keeping the liver stable in the long term and delaying or avoiding a liver transplant.”

Many people believe that cirrhosis is a disease caused by long-term excessive alcohol consumption.

Although this can be a factor in adults, cirrhosis in children is often due to a variety of liver diseases.

Doctors explained the severity of Meghan's condition and told her she had “an alcoholic's liver,” but the 10-year-old didn't understand this.

“My mum was stunned when the doctor said I had an alcoholic's liver even though I'd never drunk alcohol before,” she told BBC News NI.

“This shows there is a correlation between people suffering from liver disease and the belief that it is due to alcoholism,” she added.

The 21-year-old has never drunk alcohol and does not plan to drink in the future due to the negative effects it has on the liver.

Megan said she received a variety of reactions when she told people she didn't drink alcohol because she has liver disease.

The reaction she hates is when people say, “Well, what on earth did you do? What did you do when you were younger? When did you start drinking? Or did you have a bad experience with alcohol or drugs and it had a terrible effect on your liver?”

The medical student said the activity was an “opportunity to educate people that having liver disease does not necessarily have to be related to drinking or misusing alcohol.”

She said getting the diagnosis was “scary” but she knew she could live with the disease, albeit with limitations, as it causes extreme fatigue.

“On the outside I look normal and do normal things,” she says.

“Now, what I call normal is not what my peers call normal. I have to set limits for myself. I have to set limits for what I can and can't do.”

“It's mainly about managing my energy levels.”

She said she is optimistic about the future, but with liver disease “you can't really plan.”

“You might wake up tomorrow with yellow, jaundiced skin and find your liver is starting to fail,” she said.

“Eventually, he will have to undergo a transplant.

“It could be tomorrow, it could be next week, it could be five years from now, it could be 10 years from now. I don't know,” she said.

Megan said that if the time came, she wouldn't hesitate, saying: “It's an incredible thing to be given the opportunity to receive organs from someone else.”

She added: “Organ donation really is life-saving, but it's still a scary decision to make because you never know what's going to happen.”

“It’s a major operation and we don’t know if I’ll feel unwell, if my body will be able to accept the operation, or if I’ll develop secondary illnesses or infections after the operation.

“My liver is functioning reasonably well.

“We're not operating at full capacity, but whatever we're doing, we're doing the right thing.

“I have to wait until my liver function reaches a certain level, or until my symptoms adversely affect my lifestyle and I become extremely unwell, but the longer the biological liver I was born with stays in my body, the better.”