post hepatitis cliver transplant

I am 48 year old and I did liver transplantation 7 months ago

because of complete liver chirrosis (cirrhosis) due to HCV

, I am generally well  but in the last month myenzymes

elevated  ALT41  , AST 48 , GGT   145 ,alkaline phosphatase

11K.A.U and S. bilirubin 1.2 mg \dl.

   I am  on treatment in form of  Sandimmun (ciclosporin) dose 75

mg twice daily CELICEPT 1000 twice daily ,thanks  

[HectorSF]

Congratulations on your transplant!

Since you will be under the care of the transplant center for the rest of your life. you should be taking to a hepatologist there regarding what is happening with your hepatitis C virus reinfection in your new liver. It will be up to them as to when you will need to retreat, with what meds and how you will be monitored during the treatment process.

If you are geno type 1 there are new more effective meds to combat the virus but there have no clinical trials that included post transplant patients and the only study I know of that is going on is at my transplant center here in Northern Cali and that is only just beginning.

Your immunosuppressive agents
There are also drug interactions between Cyclosporine A (CsA) and INCIVEK when administered. So Cyclosporine must be reduced to 1/10 of its current dosage.
Also a medicine like cellcept could be an issue too. Your treating doctor will tell you all this.

Talk to you hepatologist and find out what the plan is for you treating your recurrent hepatitis C.

Good luck. Glad to hear you are 7 months post and on the road to recovery post transplant.
Hector

[mikesimon]

From: http://www.*****************.org/tbx/messages/5358/502693.html?1316445521

Posted on Tuesday, September 13, 2011 - 05:50 pm:  

"I am about 3 1/2 years post transplant. I tried the usual interferon/ribavirin therapy both pre and post transplant and was a non-responder. I have been on Incivek for 5 weeks now. It is still considered off-label use but my doctor knew I would would follow his directions so I was his first patient to try it. First I had to get off Prograf because the interaction makes the Prograf 70x more potent. I was switched to cyclosporine and Myfortic. When the Incivek was started my cyclosporine was dropped to 25 mg once per day due to their interaction. Due to my previous non-response and to the multiple variations of the HCV I carry my odds were considered to be about 30%, maybe 40% at best. At the end of week 4 the HCV RNA was not detectable. The only additional side effect is that the anemia came quicker this time. I will start Procrit injections probably sometime this week. Incivek reacts with many other drugs and my doctor insists having approval over everything I take including over the counter."

Mike

[mikesimon]

The link that was censored above is to a site called "transplant buddies". If you search "transplant buddies" you'll find the site.
A guy named Jeff posted that.
I am not Jeff.

Mike

Mike

[orphanedhawk]

I think you have to stop taking cellcept before you can do interferon treatment.

[carpediem4u2]

Pegasys/Rivavirin  treatment doesn't necessarily mean you stop cellcept. I'm a case in point.  In my case, I just had to reduce the interferon dosage.... but everyone is different.  I only do what my hepatologist tells me  :-)

[orphanedhawk]

Thanks for clarifying that for me.
I know few tp patients but I know of one who had to stop cellcept prior to doing hep C tx.

This is a good reminder that we are all different, with different bodies, health issues and doctors. What's good for one isn't necessarily good for all.