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Elevated liver enzymes post transplant ... Why?

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Posted 5/5/2014 10:54 PM (GMT 0)
Besides rejection, what can cause liver enzymes to be elevated? My mom is 12 months post transplant. Up until about Two weeks ago her liver enzymes were perfect and now we receive this mornings blood result and there was the sudden increase. What are some reasons that this happens?
Her transplant team sent her for blood test again tonight and we should have results in the morning. Has anyone else been through this?
Thanks in advance.
Posted 5/5/2014 11:26 PM (GMT 0)
Between this forum and another I am on it seems about a year out most deal with a month or two of elevated enzymes. I am sure she will be monitored and fine.

The new person who just posted is going through same thing, and I believe they said they are a year out as well.
Posted 5/6/2014 12:17 AM (GMT 0)
Hi Sean.
As always, thank you for responding to my question. Depending on tonight's blood tests results, if the liver enzymes are still elevated, the team is planning to do a biopsy. The team is concerned bc it was such an increase in the enzymes. They said, it could be rejection or "something else". Not sure what they are referring to when they say "something else". Is it possible to experience rejection at 12 months?
I did read the new posters thread but I think he /she has only one particular enzyme that is elevated. My mom has her Ast, Alt, Alk Phos and GGT that are elevated :-(

Post Edited (Worried daughter2) : 5/5/2014 6:21:30 PM (GMT-6)

Posted 5/6/2014 1:19 AM (GMT 0)
Hi Worried, I don't have an answer for your question, but I wanted to say Congrats to your Mom on her transplant anniversary. And she is very lucky to have a lovely, dedicated daughter. Big Hugs
Posted 5/6/2014 1:19 AM (GMT 0)
How high were the numbers? Glad they are doing a biopsy, hopefully that gets to the bottom of it.

I think you can experience rejection at 12 months, but others would know better. They will probably play with her meds.

Besides this how is she doing? I thought you mentioned a few other minor things gong on with your mom to.
Posted 5/6/2014 1:44 AM (GMT 0)
WD,

Asa you might remember I am 9 months post tx. My enzymes spiked up to the 300 level in mid march. I had a biopsy on March 24.
I was told it could be rejection, denov auto-immune hepatitis or CMV hepatitis. My biopsy and blood work showed CMV hepatitis , and I was out back on a double dose of Valcyte. (Note I was CMV neg. pre tx and exposed by donor)
In mid April, my dose was reduced to 900 mg per day and as of last week, my enzymes are around 40 and Alk phos back in the 80's.

I have to remain on Valcyte until end of July and then! they will attempt to take me off it again.

Susie
Posted 5/6/2014 3:12 AM (GMT 0)
You can experience rejection at any time. I follow a transplant forum and rejection is fairly common. Luckily the meds they use take care of the problem.

Anyone who would like to get the website of this forum should email me and I'll send you the address. There are hundreds of people there with transplant experience, far more than here. If you have had a transplant, or are awaiting one, you need to go there, as well as here.
Posted 5/6/2014 3:14 AM (GMT 0)
@ themiz... Thank you very much. My mother means everything to me. She makes sure our family is all taken care of and is an extremely devoted mother with a heart of pure gold.

@ Sean... As of this morning, the numbers are:
Alt 180 high
Ast 54 high
Alk Phos 134 normal - but higher end of normal
GGT 103 high
I will find out tomorrow morning if she will need a biopsy.

@susie...I am very happy that you are much better with your liver enzymes. It's is very scary to not know exactly what is causing this. How was the biopsy? Painful? Any advice?

@david...really? Rejection can happen at anytime? Is there a specific trend that the liver enzymes follow to indicate rejection oris a biopsy the only way to confirm it? I will email you tomorrow for that forum site info... Thanks !

Post Edited (Worried daughter2) : 5/5/2014 9:17:40 PM (GMT-6)

Posted 5/6/2014 4:13 AM (GMT 0)
Hi WD! Yes, a transplant recipient (of any organ) is at risk of rejection for the rest of their lives. The body looks at any transplanted organ as something foreign and is always trying to get rid of it - that's the reason for the anti-rejection meds. That being said, the farther out you are from transplant, the less chance of rejection - but the chance is always there. The vast majority of acute rejection episodes can be controlled with medication adjustments/replacements/additions. So IF this is what's going on with your mom, they will probably just tinker with her meds and she'll be fine. And yes, they do a biopsy to confirm rejection.

Have a peaceful night. :-)

Post Edited (Splashdancer) : 5/5/2014 10:19:02 PM (GMT-6)

Posted 5/6/2014 11:58 AM (GMT 0)
WD,
The biopsy was a breeze. it was just the anticipation for the procedure and the waiting for the results that were difficult. They did a percataneous biopsy, numbed the area and gave me an iv sedative. I was awake during the procedure but did not feel a thing. I had to stay 21/2 hours post procedure in observation in case I had a bleeding issue. So, it was a long day!
Posted 5/6/2014 2:58 PM (GMT 0)
@ Susie...did your liver enzymes continue to trend upward until you started back on Valcyte? Just wondering if somehow, they started trending downward PRIOR TO any medication intervention? The whole biopsy process is really scaring my mom but I will tell her about your experience... Thanks.

@ splashdancer... Thank you so much. We are extremely stressed about what's happening. Just the words. "Rejection" have a huge impact. Let's see what the doctor says today.
Posted 5/6/2014 5:13 PM (GMT 0)
My enzymes did not start to go down until I was back on the anti viral medication.
Posted 5/6/2014 9:31 PM (GMT 0)
So far, it seems like the enzymes are trending downward. Ultrasound was done and all is okay. Team is not sure why the enzymes went up. Bloods again later this week.
Thank you everyone for all your help and support. You are all awesome! What an amazing forum!
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