elevated ast,alt

My son ( 9.5 yrs) had transplant June 2008 ( 15 months post transplant) still has few issues, can any one help. His recent tests showed elevated ast and alt  124 and 199 respectively ( range 0-42 & 0 -60 respectively) . Since last 6 months it was always in the normal range. Also his Alkaline phosphate is down for the first time ,it is 100 ( range 117 - 390).


His biopsy report was normal tested in July'09.

He was taking 2 mg bd tacro and 2.5 mg wysolone after elevated IGg Mycept 250 mg was added since last 1st July, 2009 and on 1st august, 2009 igg came down from 5000 to 2350 level Globulin was also 4.1 ver close to normal for the first time .Now after continuation of these drugs for 2 months His Globulin went up to 5.10 (it is normally elevated hovering between 4.5 to 5.5 ( range 1.8 -3.6), Also he had issues with Igg went upto 5000 now still out of range but little higher 2186 ( range 650-1600).

Please tell me if there is some change or addtitional medicine  require for
1. elevated ast& alt,
2. elevated Globulin
3. elevated Igg
Kindly give your honest opinion if this is normal that tehese tests will show irregular results through out the life or they get stablised after certain time. My son is a extra ordinary active both physically and mentally. Kindly advise.

Regards

[Thomas D Schiano, MD]

children undergoing liver transplantation may develop an autoimmune hepatitis type picture post-transplantation that is marked by high ALT and AST as well as hypergammaglobulinemia.  What you describe sounds like this can be present, although I cannot reconcile why the biopsy is "normal".  With ALT this elevated the biopsy should show something.