chronic liver rejection

we already have excluded billiary tract obstruction by performing MRCB, and viral hepatitis by virology tests,and afraid of the biopsy due to his low platelet level,now his billirubin level reached 29 and his prografe level is 16,his daily dose of prografe is 1mg twice daily,what shall we do and what are the possible consequences of this case,and how long can his liver bother this rejection?

[Thomas D Schiano, MD]

unfortunately if the bilirubin is that high i think retransplantation will need to be considered.  i would still consider a transjugular liver biopsy to make sure that there is no component of acute cellular rejection that could be treated with steroids.