Elevated liver enzymes 17 months post liver transplant

Hi katebw. I have had 2 biopsies (Dec and January) and an ultrasound (a week ago) since last April's whole liver transplant due to alarming spikes in my liver enzymes. I can relate to not only the fear that your bidy is rejecting the liver and also the uncertainty when there is no known cause. When you know you are folliwing post care instructions to the letter you know there is nothing you can change to make it better until the cause of the spikes are discovered.
I still have weekly blood draws even though I am just 2 weeks out from my transplant's first anniversary. I am reassured by Mayo's vigilance to catch any ptoblems asap. At times I feel tethered due to the immediate calls to come to Mayo for testing so travel plans are put on the back shelf.
So as we all do I am living each day as best I can with appreciation, joy and gratitude and in my case occasional moments of fearful concern as I await test results.
You are not alone. Barbara

Good morning

I'm not a Dr but I have shared some of the same experiences. I believe a Doppler ultrasound is so the Drs can measure the amount of blood flowing through the liver. I am 2 years post liver transplant and have had a few dopplers before my transplant and annually post. Stay positive and have faith in your team. Remember they're here for you.💗

Hi Katebw, I to have had an acute rejection post liver transplant 2.5 yrs. They did the Doppler US to check the bile ducts are working properly. The cause for the rejection is unknown too. I was so very scared too. The good news is the enzymes are back to normal and I chose not to do biopsy and wait and see if they would go down. TP team was ok with this but if they insisted I would have had it done. I just did not want to do anything to upset my liver💚💚
You hang in there and know we understand.😊😊

Thank you, @myfablife. This is such helpful perspective to have. Part of my fear is about a potential biopsy which I’d also like to avoid. I really appreciate your responding to my worries.

Thank you, Barbara, @ajdo129 . It’s so calming in your company,

Hi katrbw I am glad I could help ! Please let me know how things go💚

Hi katebw. My two biopsies were relatively simple. It is an outpatient surgery where your liver is first mapped by imaging. Then you are mildly sedated so you can hold your breath as the doctor does a minute incision in your right side by the ribs. It is so quick I asked if they had gotten the sample as they were putting a small bandage on my side. Because of the sedation you will need a driver to take you home. I was just a little sore by my ribs for a day.

I have read in medical information that if my liver biopsy did prove positive for an infection that would lead to rejection, the next step would be a week long treatment of high doses of prednisone for first day, test the next day, lower dose pred day 3', test the next day, lower still prednisone on day 5. Then there is an evaluation to see if the infection is gone. This step has a high success rate. So there are steps before it is even known if you would need a new liver.

I know it can be scary to think that you might have to go through the transplant process again but not only are there many reasons why enzymes can spike, there are also healing avenues too. FYI since my diagnosis I have met three people who either had or had relatives who had second transplants and all three are doing well.

I hope this info sheds light in what may seem like a dark hole. Barbara aka ajdo129

Thank you, @ajdo129 Barbara! This is really helpful and so appreciate the care you took to write to me in good detail. Bless you.

The dipper will identify rejection and other items. In my case they found a pressure build up due to scar tissue pinching the blood flow. This was corrected via a procedure. However my enzymes are always at the upper end of normal abd slightly above. I am 27 months post

@bobscozz0927 Thank you- helpful to know there are things to look for other than rejection. I guess let go of my catastrophic thinking! At this point my #s went down a little and they will be checked in two weeks. At that time they may do a Doppler but we’ll see. Hard to wait.