517301?1229801385
Thomas D Schiano, MD  
Male
New York, NY

Specialties: Internal Medicine, Gastroenterology

Interests: Viral Hepatitis, Nutrition in Liver Disease

The Mount Sinai Medical Center
877-241-4983
1190 5th Avenue
New York, NY
My Posts
ALT/SGPT High
Feb 08, 2012 in the Liver Transplant Expert Forum
it could be fatty liver or from taking herbal supplemsnts. get an abdominal ultrasound if you have not already had one. theae are definitely not concerning elevations.
Liver Cramps ?
Feb 08, 2012 in the Liver Transplant Expert Forum
abdominal cramps could be realted to the liver condition. What are you taking for immunosuppression? leg cramps are typically worse at night and may be related to be dehydrated. keep well hydrated and/or take zinc capsules
Can Transplant reduce FEV1 lung parameter?
Feb 06, 2012 in the Liver Transplant Expert Forum
...a very good question. I really do not think so although there rarely can be some diaphragmatic nerve injury at the time of the transplant. if one is splinting due to pain, the FEV1 I presume would be decreased but it should not be decreased on a chronjic basis as far as i know.
switch from cyclosporine to sirolimus
Jan 31, 2012 in the Liver Transplant Expert Forum
there is also a risk of precipitating rejection when switching immunosuppressive agents. there is some early data to suggest that rapa may have a better effect on HCV replication though.
switch from cyclosporine to sirolimus
Jan 24, 2012 in the Liver Transplant Expert Forum
my first suggestion would be whether they could decrease your cyclosprine a little bit more. My personal bias is to not switch the immunosuppressive agent. rapamune can be difficult to tolerate. i am happy to hear that your renal function is OK. i think you will continue to do OK
what to do
Jan 23, 2012 in the Liver Transplant Expert Forum
transplant centers definitely differ as to their recommendations. the MELD decreasing is a good thing. Sometimes it remains possible to get transplanted at a low MELD score with a B blood type.
pregnancy
Jan 19, 2012 in the Liver Transplant Expert Forum
yes--certain meds such as rapamune are not allowed during pregnancy however. its more ideal to wait until after the 1st year when you will undoubtedly be on less immunosuppressive medications and less medications altogether
question about immunosuppressants
Jan 14, 2012 in the Liver Transplant Expert Forum
it is believe that the HCV may have an accelerated disease course in part due to the use of immunosuppressive medications, but the exact mechanism by which this happens is not well understood. The use of antiviral therapy for recurrent HCV should itself not be adversely affected by the immunosuppressive medication but protease inhibitors can affect the metab...
liver cancer diet/supplements
Jan 12, 2012 in the Liver Transplant Expert Forum
not as much for liver cancer but as hepatoprotective herbs: echanacea, milk thistle, selenium,licorice root, astragalus, schisandra, CoQ 10, SAMe
what is the best tx for cholangio
Jan 12, 2012 in the Liver Transplant Expert Forum
tumors in the caudate are more difficult to treat since they get blood supply from both lobes of the liver. External bean radiation may be an option actually. I am not sure that microspheres would be effective frankly. Another option might potentially be brachytherapy with cholangioscopic placed beads