Mycophenolate & Tacrolimus: Anyone have elevated liver enzymes?

My liver enzymes went out of whack a year ago, when they had already taken me off Tacrolimus. It was 10 months after my bone marrow transplant and I had been doing well and feeling good. My doctor attributed this to GVHD, so he put me back on Tacrolimus and much higher Prednisone - 70 mg/day at one point. Eventually the liver enzymes went back to normal but it took several months. I’m still on Tacrolimus but they are slowly weaning me off of it. I hope you get better results soon!

Thanks so much @edb1123 for jumping in to help me! 😊 Approximately how high did your liver enzymes go? I am a kidney transplant patient and my liver enzymes have been elevated since my transplant two years ago. After CMV virus, my Cellcept was reduced and my liver enzymes improved but are still elevated. I am coming up to two years of elevated liver enzymes and for the last six months my BUN level is also going higher. From what I am reading on the internet, it can be caused by Cellcept, Tacronlimis and sometimes the combination. (I also read that BUN can relate to liver function, which I did not know). I am concerned that they may need to change my meds which scares me about possible rejection. I am also not sure which drug they will change the Tac or the Cellcept MMF...or reduce first. It sounds like you needed the Tac to solve your liver enzymes increase. I think I am going to need a reduction of one of them (or a change). As usual, I am high anxiety about possible liver damage after two years, my higher BUN level, and the possibility of rejection when there is a change in medication. So, I decided to post and hear other people's experiences, like your successful story! Thank you for sharing your story. It's very helpful. 😊

@hello1234 My husband recently had elevated liver enzymes also. He is almost 6 years out from his transplant. When I mentioned your post, he said he figured his results were caused by his lifestyle for a while. He was away from the house here, camping and working a contract job. He was drinking more than usual, and eating a lot of restaurant food. When he came home he went back to the "regular" diet he had been on, and told me his values dropped back towards what they had been.

Not sure if I can convince him to look more into the values to see if he has the same issues as you, though. I will be interested to hear what his doctor thinks, and especially the transplant team he will see in a couple months for his annual check-up.
Ginger

Hi @gingerw 😊 Thank you so much for sharing that story with me! I am going to my local nephrologist in two weeks. I am currently scheduled for my 2 year anniversary appointment at Mayo Florida in late August, which I am starting to think is too long to wait. Do you think I should try to move up my scheduled appointment with Mayo, or call my transplant coordinator, or ask my local nephrologist to call Mayo for advice? Has your husband's local nephrologist ever called Mayo to speak with them to consult?

Hello, hello 1234! 😊
Yes, I looked back at my test results from last May and June, and my AST was 630 vs. normal max of 43, my ALT was 836 vs. normal max of 45, and my Alkaline Phosphatase was 219 vs. normal max of 104. I don’t think I ever had a BUN test - it may be unrelated to bone marrow transplants. I’ve never taken Cellcept, so I can’t comment on the difference between that and Tacrolimus. In my case, I believe the high dose of Prednisone is what resolved the liver enzyme issues. I hope you get the necessary medication to resolve your issues!

@edb1123 Thank you so much for double checking your liver enzymes numbers for me. It was very kind of you to double check. I really appreciate hearing your experience and that ultimately it was resolved. You are correct.
Your numbers were really high too, so it's great to know that you received an effective solution.
Hopefully, I will have similar success with my medication adjustment or changes! 😊

@helpful1234 My husband was not transplanted at Mayo, so I don't think his nephrologist will do more than contact his transplant team, if there is a question. I can suggest you speak to your transplant coordinator, and let them know your concern, let them guide your next steps.

Nothing worse than being anxious. For tonight and tomorrow, put these issues aside, find what makes you happy and relaxed, and do that. Okay?
Ginger

@gingerw Excellent advice Ginger! Thank you ❤❤❤