Brother just had liver transplant

  My brother had a liver transplant on 10/2/98.  The operation went smoothly, and he was sent home after only 6 days. ( He also has diabetes, which I understand will now be more difficult to control.)  Prior to the transplant, he suffered sporadically  from  'liver flaps'.  Immediately after surgery, he showed what still looked like minor liver flaps, but we were told it was the effects of the cyclosporine, (this medicine I understand will cause minor trembling or tremors).  His tremors have become so bad that he was readmitted into the hospital -- he cannot feed himself or walk without his body trembling out of control.  He also has muscle weakness in his right arm (possible from all the IV"S), and the tremors are severely evident when he puts any pressure on his muscles, such as lifting a cup of coffee or a fork or when trying to lift himself out of bed or just holding his arm or leg out straight.  The doctors do not seem to know what it is (we;ve had many different diagnoses, such as it's all in his head to they have no idea what is causing it).  Neurology has reviewed all bloodwork and they find nothing.  Also, his blood sugars range from the 60's to as high as 455, even with an Insulin drip in place.  Could this actually be an effect of the cyclosporine or steroids?  Or could his diabetes have anything to do with it?  One doctor even mentioned that his symptoms mirror those of multiple sclerosis.
  Any input would be greatly appreciated.

[HFHSM.D.-D.M.]

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Dear Donna:
I really appreciated your question and I can imagine how frustrated you are.  Patients and their families are so relieved to actually get a liver transplant, it can be frustrating to realize that there can be significant problems after the transplant.  The first year after transplant can be especially frustrating.
Diabetes is a common problem after transplant.  It can be a new problem in someone who never had diabetes before or it can be harder to control in someone who already had this problem.  The culprit is usually the steroids (prednisone or medrol) which makes an individual