Elevated liver enzymes (post transplant)

Hi!
My mom is 2 years post transplant. Never had an issue with the liver enzymes (ALT, AST & ALK phosphate) - they have always been in the mid normal range. Within the last few weeks, they have all slowly started creeping up to the high end of "normal" and the ALT was actually slightly elevated today. Also, her creatinine level is very, very slightly elevated. Our Transplant coordinator is waiting for her trough level to come back and then piece all the info together. Just wanted to reach out to those post transplant to see if they have ever experienced this and what may of been the cause - Is it possible that it could be that her anti rejection meds need to be lowered? Could it be something else going on?
Thank you in advance.

Hi David.
Did you doctors decrease your prograf dosage to see if that helps your creatinine level but still maintain a trough level that is right for you?
My mom is diabetic so that does not help her kidneys.
Have you ever experienced elevated liver enzymes (post transplant)?

Wd2.

Good to hear from you, though I wish you were writing to say you were on the way for a 6 week cruise of hte Greek Islands and were expecting to dance every night! Maybe next year!

Just so you know, Mike's labs have been up and down since TP (4 years now).

He had some "mild rejection" on a biopsy at year 1 and they up his prograf even though his createnine wass usually something like 1.6 or 1.7.

The labs were worse and worse as his Hep C kept on attacking the new liver until he had treatment, and then his numbers settled down again, but he has some liver damage from that in between time. Oh my.

When he had pancreatitis his MELD score crept up to like 12 or 13 and I started getting nervous.

And the lfts have been up and down with the prograf. He was on 2mg am/ 1 mg pm, then 1 mg am/.5 mg pm.

Then they added a second antirejection drug Zortress (everolimus) at 1 and 1 with the lower prograf dose with the idea of it being more gentle on the kidneys. He sees a nephrologist who is keeping a good eye on the kidney stuff.

Then he had some surguries last winter....AORTIC VALVE REPLACEMENT and a hug INCISIONAL HERNIA. And a hospitalization for acute pancreatitis.

The Zortress is counter indicated for surgury, as it would not allow the wound to heal...so they took him off that and bumped him back up to the higher prograf dose, though the createnine jumped up again. After 3 months off the Zortress they have reintroduced it and reduced the prograf. And are monitoring the levels every two weeks.

I think each person is different, and they are trying to manage each patient individually. I am certain your coordinator and docs will be very alert to the changes in your Mom's labs and her feeling of wellbeing.

Is she feeling well?

I certainly hope so.

Hugs,

Mama Lama

I wanted to pop in and say hello, WW2. Sorry you are concerned. Hope things are just needing a minor tweek.

Two years! It seems like you were just waiting for her transplant.

I hope your Mom is having more good days, than bad. Take care of you. Big Hugs

Still waiting for this weeks blood test results. I do have another question about labs - do those who are post transplant, find that their WBC's tend to be low? Also, I find that the CBC such as the neutrophils, monocytes, absolute lymphs, absolute neutro, band, mono, etc.,., tend to fluctuate - sometimes in the normal range, sometimes low, sometimes high. Is this typical due to the immunosupression meds?

Thank you.

@ MamaLama - she has her good days and bad days. Her WBC have always been low post transplant. The neutrophils, monocytes, the absolute lymphs, etc (I don't know if these are called the differentials part of the blood test) that go up and down. Do you know if this could be due to the immunosupression drugs?

Glad to hear that Mike is doing good 😊

@mamalama - yes the creatinine is definitely something that is looked at very closely and we do get very anxious when it starts to creep up. Does Mike take Prograf or the genetic Tacrolimus?
How often does Mike go for labs? Does he still continue to get MRIs - and how often?