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Liver Transplant (Expert Forum)
TLC 2.8 for last two weeks
Answered by
Thomas D Schiano, MD - Internal Medicine, Gastroenterology, Liver Transplantation, Hepatology
The Mount Sinai Medical Center
New York - NY
Questions posted in the Liver Transplant . Forum are answered by medical professionals from The Mount Sinai Medical Center.
TLC 2.8 for last two weeks
by rbahuguna, Oct 21, 2009 10:22AM
My mother had liver transplant two and half months back here in Delhi, India. Till two weeks back she was on PanGraaf 4mg, Wysolone (steroid) 15mg and CellCept 1000 mg a day. At that time (i.e. two weeks back) her blood result showed that her TLC has slipped to below normal (which is minimum 4) and was showing as 2.8. Her Haemoglobin seems to have settled around 11.2. All other results including Blood, LFT, Creatine etc show normal. Doctor reduced her CellCept to 500 mg (from 1000mg) and increased PanGraaf to 5 mg (from 4mg) and Wysolone (steroid) to 12.5mg (from 15 mg). One week later she had the tests done again. The test result shows that her TLC has not moved an inch and is still at 2.8. My father is like panicked (he has always been a bit nervous personality anyway). The doctor - does he suspect virus infection, I am not sure - prescribed a blood test, result of which comes out after a week or so. Is this situation - TLC at 2.8 for two weeks now despite CellCept being reduced to Nil mg - is so serious a problem as to cause worry? I am not sure how serious is this is - I am not doctor. Please give your comment
Doctor's Answer
by Thomas D Schiano, MD, Oct 22, 2009 06:55AM
, Oct 22, 2009 06:55AM
some patients metabolize the prograf much more than others, especially after a partial liver transplant. It is still early after the transplant. as long as the liver tests are OK, he shouldn't worry. They should slowly push the dose of the prograf up, while he is taking the cellcept.
Member Comments (3)
by rbahuguna, Oct 26, 2009 10:28AM
The doctor says he proposes to take my mother off CellCept altogether at some point in time and only PanGraaf will be needed for the whole life - in the meantime the doctor may prescribe CellCept in on / off basis.
by Thomas D Schiano, MD, Oct 27, 2009 06:57AM
, Oct 27, 2009 06:57AM
i agree with the plan
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