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question about rejection...

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Posted 8/23/2013 4:47 PM (GMT 0)
Got a call from our TC...my mother's liver enzymes are elevated.
AST - 43 (normal 7-40)
ALT - 104 (normal 0-45)
ALK PHOSPHATE - 176 (normal 40-150)

They are increasing her Prograf from 2mg, 2x daily to...3mg, 2x daily.

The TC said this could possibly be the first indication of rejection!!! She had her labs drawn this past Monday (5 days ago) and they were in the "normal" range. Now, 5 days later they are elevated! However, on Monday afternoon, she started taking both Levofloxacin 500mg 1x daily and metronidazole (flagyl) 500mg 3x daily. My mom had diverticulitis, that's why those meds were started. Just curious...could those meds contribute to the elevated liver enzymes?

Also...if anyone else has experienced rejection...what will the transplant team do? Liver biopsy, treatment, etc???

Post Edited (Worried daughter2) : 8/23/2013 12:17:57 PM (GMT-6)

Posted 8/23/2013 5:31 PM (GMT 0)
Don't you think you should address these questions to her team???

I get the feeling you don't have faith in them. Stop second guessing everything. If there are signs of rejection as there often is, they adjust the meds. We sure don't know specifically what the team will do, that's why you HAVE a team. Talk to them.

Labs fluctuate all the time, relax. They know what they're doing.
Posted 8/23/2013 5:40 PM (GMT 0)
Exactly, Mae. If you have questions, WD, that's what the TC is for. I pestered mine relentlessly in the beginning (and sometimes now.) When she gives you info, don't just hang up. Ask whatever questions you have.

My enzymes went up a short time after transplant, too. They have taken nearly 2 yrs. to normalize. And my Alk-Phos is 174. This is due to the hep C. Your mom's AST is normal. They are doing what they always do in these situations--increase the Prograf and sometimes other meds. Or add meds. This is what they do and they are good at it. They will watch to see if labs continue to rise or decrease over the coming weeks. They could possibly do a biopsy if enzymes continue to rise. I've had 2 since TP.

But for now...RELAX. Again.

Hugs,
Connie
Posted 8/23/2013 5:45 PM (GMT 0)
@ Mae...I have addressed these questions/concerns with her team in full detail. They answered all my questions and have been extremely informative. My mom has an EXTREMELY amazing team of doctors. I NEVER questioned their ability. That's not what my post is about.

I am here just trying to see if anyone else on this forum has had an experience with using antibiotics and inturn, had their liver enzymes elevated. Sometimes, sharing experiences and discussing issues with other patients and caregivers, you get a different perspective.

When you hear the word "possible rejection", I can't imagine that no one (caregivers or patient) would not worry or be concerned.

@ Connie...you always make me feel better. I will try my best to relax. We are at a great place, so I do feel extremely comfortable and trust my mom's team 1,000%.

Post Edited (Worried daughter2) : 8/23/2013 1:07:39 PM (GMT-6)

Posted 8/23/2013 7:08 PM (GMT 0)
Just wanted to include this information...I am showing what her liver enzymes are today and what they were Monday. Her Alk phosphate more than doubled and her ALT went up 8x more than it was just 4 days prior.

AST - Today 43 & Monday 12 (normal range is 7-40)
ALT - Today 104 & Monday 45 (normal range 0-45)
ALK phosphate - Today 176 & Monday 68 (normal range 40-150).
Posted 8/23/2013 7:22 PM (GMT 0)
WD, it IS possible that the antibiotics caused the rise in enzymes. Is she still on them? At any rate, the team will wait and see if they improve with the increased meds.

Hugs,
Connie
Posted 8/23/2013 7:41 PM (GMT 0)
@ Connie...yes, she is still on the antibiotics. She needs to be on them for 6 more days because of her diverticolitis. I am very curious if there is any correlation between the elevated liver enzymes and the antibiotics? Up until she began the antibiotics, the liver enzymes were well in the normal range. Or...it just may be a coincidence. As if this evening they have increased the Prograf from 2mg 2x daily to 3mg 2x daily...so hopefully the increase will help.
Posted 8/23/2013 8:10 PM (GMT 0)
DivericulItis. DiverticUlitis. DiverticUlitis. Get it?

I stated above that it could very well be the antibiotics. Don't worry about it. See how she's doing in a couple of weeks.

Hugs,
Connie
Posted 8/23/2013 8:35 PM (GMT 0)
@ Connie...LOL...I got it...I need to fix my spelling. Thank you :-)
Posted 8/24/2013 12:08 AM (GMT 0)
WD,
I have had several bouts of Diverticulitis ,and I am not a TP patient. I have been on the same meds as your Mom,my counts for my liver have gone up. Dr told me its a combo of the meds and the infection itself.
Hope this helps !

Robin
Posted 8/24/2013 12:17 AM (GMT 0)
@ notenoughhelp...Thank you, Robin. Keeping fingers crossed that it is not possible rejection. Did your doctor ever prescribe Lialda (mesalamine) for your diverticulitis?
Posted 8/24/2013 4:25 PM (GMT 0)
The Surgeon said I am supposed to be on it,yet no prescription has ever been given to me ? I see the Dr this week for more tests and again the middle of Sept. As of now it looks like I will be having a bowel resection. But wont know anything definite until after this next test.

Robin
Posted 8/27/2013 4:28 AM (GMT 0)
@ Robin...keep us posted on your upcoming tests. Which tests are you having done? Diverticulitis is no fun :-(
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