My husband, 54, post transplant on 1/10/10, elevated ALT ans AST in April 2010, started dbl TX 135 pegasys and 600 riboviron, also Procrit 20,000 twice a week and Neupogen 300 once a week. He ended all treatment in December, 2011 as directed from MGH, as we had been referred to Mayo Clinic in AZ for triple therapy TX. MGH and our Vermont Hepatologist referred us to Dr. Hugo Vargus, at the Mayo Clinic in Phoenix, AZ in December, 2011. We decided to buy an RV and travel (bucket list style). We ended up here for our Apt at the Mayo Clinic, only to be told, they have never treated anyone post transplant that have not transplanted at the Mayo Clinic . . . Go figure!!! So the dbl tx ribo/peg was stopped in December, and Gary's labs blood wise have started to rise a bit, but his liver enzymes, BUN, alk phos, and viral load have gone up . . . VL is now 18 mil compared to 1 mil in December! We are trying to figure out if searching for another clinic to tx him with the triple therapy is a good idea or not. MGH is not using the triple therapy on their post transplant patients, don't know why, but they just are not....Any advise will be appreciated . . .
December 27, 2011 labs . . . VL 1.2 mil, Creat .9, BUN 10, Alk Phos 88, Mag 1.9, Pot 4.7, Alb 2.7, AST 31, ALT 23, Billi .3, HCrit 30.7, Hglobin 9.4, RBC 2.93, WBC 2.9, Plat 78.
March 8, 2012 labs . . . VL 18 mil, Creat 1.0, BUN 31, Alk Phos 160, Mag 1.7, Pot ?, Alb 3.9, AST 63, ALT 70, Billi .5, HCrit 41, Hglobin 13, RBC 4.1, WBC 3.9, Plat 85.
That is all I have . . . His mental status is slow, his ST memory is non existent, close to 10%, his irritability is high like a 8 out of 10, his insomnia is high, he sleeps maybe 4 hrs straight, if lucky (he takes Ambian CR 12.5 every night, Trazadone 100mg every night, and Remeron (Mirtazapine) every night) He still has insomnia . . . Gary is tired when ever you as ask him. He is eating more since stopping dbl TX. He also has had Type 2 diabetes since pre transplant, he is insulin dependent, He uses Novalog 70/30 mix twice a day, and regular Novalog short acting as needed.
Thanks to everyone who reads this and gives us their advice. We are feeling so unsure right now.