minimum anti rejection medication?

My wife had a successful liver transplant in August of 1992!  (She had fulminant liver failure, the cause never 100% determined--either related to Still's Disease or an idiosyncratic response to aspirin being used to treat the Still's Disease, and had a transplant that failed due to rejection one month before the successful one.)  She's had one very minor episode of rejection, about 5 years out, successfully treated with short term prednizone and short term raising the dosage of her then regular medications--tacrolimus and cyclosporin.  She shifted to cellcept about 6 years ago and has slowly cut back the dosage--presently taking 500MG Cellcept 2X a day and nothing else.  We wonder if this is very low in your experience or if you know people on even lower dosages.

Thank you very much,
Paul

[Thomas D Schiano, MD]

we very rarely if ever maintain patients on cellcept alone after liver transplantation and try to keep patients on very small doses of cyclosporine or prograf paired with cellcept.  raramycin is an alternative agent if the patients has renal dysfunction or another contraindication to the use of prograf or cyclosporine.  I would be concerned about the possibility of rejection with the use of cellcept alone.

i hope this is helpful.