Elevated liver enzymes post liver transplant

Hi @crystalfaye 😊
I am a two year post kidney transplant patient. Pre-transplant, I never had elevated liver enzymes or any liver issues. But after starting the immune suppression drugs, my liver enzymes became elevated and stayed there until the following year when my Cellcept dosage was reduced in half. After the reduction, the enzymes stayed elevated, but they were now in the high normal range. And now, a year later after the Cellcept was reduced, the numbers are back in the low normal range. I am a kidney transplant patient, not a liver transplant patient, so of course your doctor will be the best source. Are you taking Cellcept and Tacronlimis? Are you also taking drugs like Bactrin? I have learned that these medications can all cause elevated liver enzymes however in the early months after transplant, they sometimes make the decision to put up with the elevated liver enzymes. They reduced my Bactrin first to Monday, Wednesday, Friday instead of every day. That had a small minimal effect. It was the Cellcept that needed to be reduced. Is it possible that your elevated enzymes are caused by the meds too?

@crystalfaye I’m 9 months post liver transplant and my alkaline phosphate trends high, often in 130s. Two weeks ago I was feeling lousy with GI symptoms and it was 165! My team says that newly transplanted livers are often inflamed for a while, plus medications exaggerate inflammation.

Hello and thank you for your response. 😊 I was on Bactrin until about four weeks ago. The surgeon felt that is was affecting my potassium levels. He changed it to this yellow liquid stuff called Atovaquone and my level went back to normal.

I had my clini appointment today and the surgeon saw lowered my Celcept. We’ll see how that affects my blood work.

In the meantime I am being scheduled for an MRI of the stomach to rule out a bile duct restriction.

Are you having any additional issues since your transplant? Are you able to return to your normal routine?

Hi @crystalfaye 😊 I am so happy to hear that your Cellcept dosage was reduced! Are you now taking 500mg bid of Cellcept in addition to Tacronlimis like me? I think you will start to see a nice decline of your liver enzymes over the coming weeks and months like I did. A year later, I am finally in the normal range for ALT, AST and ALK. As you and I know, with our Bactrin situations, the meds definitely affect the blood levels of different enzymes (including potassium), etc.
It's also a great idea to get an MRI to double-check that there is no bile duct restriction so you can feel confident and relax knowing that "all is well". When you are a new transplant, we worry about EVERYTHING so it's nice to have all the tests so you know there is nothing missed or overlooked.
My transplant challenges have been things like leukopenia, neutropenia, elevated liver enzymes, active CMV virus and just this week my lab results came back BK virus positive. All that said, I am back to my normal routine and I feel really good. I am happy and very grateful to report that all of my challenges have been fairly minor annoyances with ultimately excellent outcomes. How are you doing? Do you have any other concerns or worries in addition to the elevated liver enzymes?

Good morning!!!! My apologies for a delayed response. I am now taking 250 Cellcept in the morning and evening along with the Tac . I was previously on 500 in the a.m. and p..m. I went for my MRI but wasn't able to complete. My claustrophobia got the best of me and I had to be pulled out of the machine. This had never happened to me in the past but I know that I am really a different person since my liver transplant in June. I have been rescheduled for mid September with IV sedation

I am so happy that you are feeling well!!!! That is awesome!

I am just feeling ok. I sure do run out of energy quick and have quite a bit of nausea in addition to excessive itching. I know in time this will get better. I am able to do so much more for myself and around the house which is a blessing.

Please refresh my memory. When did you have your transplant?

This info is definitely helpful. Thanks! I too have a lot of GI issues. Not fun!

Have you had any other issues along your recovery journey?

Hi @crystalfaye 😊
(I am a two year post kidney transplant).
Regarding your MRI, I know how you feel about the claustrophobia. During my last MRI , I was on my last nerve too. I hadn't remembered the banging noise level to be as loud as it was. There was no way to distract yourself with the music in the earphones because of all the jackhammer banging. Horrible. It's a shame you have to go back. Isn't there a way they can check the bile ducts using ultrasound or Cat scan instead of MRI with sedation?

Hang in there, @crystalfaye. Your positive attitude is admirable and we are with you 100% ❤️

@crystalfaye my main issues have been some GI stuff/ I have ulcerative colitis also so it’s partially that. I was in the hospital in May as I got a stomach flu and was very dehydrated. That’s been ok. The amount of water I drink is huge yet sometimes my creatinine is a little high. My primary issue has been my back with which I’ve had trouble since I had a big fall pre liver transplant due to hepatic encephalopathy. It became worse due to many factors. It does interfere with my life but it doesn’t scare me since it doesn’t point to other problems. I’ve been lucky so far with no major complications.

As a matter of fact I have been scheduled for an ultrasound next week. 😊