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Itching and liver engimes are high after 1.5year of liver transplant
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Itching and liver engimes are high after 1.5year of liver transplant

Dear Sir,
   I am writing again after a long time on the same issue. i.e liver engymes are high since last December. In the mean time USB and MRCP showed that there is IHBR dilation in the posterior bile duct but not much. It can not the cleared my ERCP as the bile ducts are reconstructed in a different way. In between liver biopsy also done. There is no evidences of rejection and the HBV DNA also negative.
Doctors are not 100% sure that  the reason of elvevated engymes is dilated IHBR,

Present
Bilirubin : 4.35 ( gone up further in last 15days)
SGOT: 166 ( come down in last 15 days)
SGPT: 64( Come down in last 15 days)
GGTP: 290(Come down in last 15 days)
Alkaline: 140 (come down in last 15 days)

TLC : 2100( came down drastically after withdrawn of wysonole)
Creatinine : 2.3 ( gone up)

Please let me know your opinion.
517301_tn?1229801385
unfortunately you need to either have a liver biopsy or PTC of the bile ducts to explain why the liver tests are elevated
4 Comments
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Avatar_m_tn
Thanks for your comment. Liver biosy was also done. It shows no evidence of rejection and not significant imact of bile duct obstruction.
PTC not done yet.
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517301_tn?1229801385
a PTC probably needs to be performed
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Avatar_m_tn
Dear Sir,
After a long time it is diagnosed that the anterior duct(which has anastomosis stricture) is also larger obstruction. 25th June ERCP was done. Since then I am having dark(brown) stool even after 7days.
Todays LFT and CBC report showing that bilirubin still high(2.77) remains at same level as was at the time of discharge and SGOT(487) SGPT(388) increased. And most important think Hb has gone down to 9.1 from 12.1 before the procedure. What could be the reason and what should I do according to you,

ERCP report is as follows:
"Papilla identified. Needle Knife papiloctomy done . Guide wire egotiated into CBD. Cholangiogram done revealed anastomosis stricture. Stricture was dialated with Sohendera bilary dialator. A 7 Fr X 15Cm stent put across the stricture in the one of the systems."

Regards,
Phalguni
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