My mom had a living donor liver transplant back in January 2010 in China. in 2013 she started her HCV treatment and since they she has been un-detected for HCV (HCV free). She did pretty good after the transplant for about ~3 years. In December 2013, we took her to a reputable hospital in NC (liver transplant center) and they diagnosed her with liver rejection and found ascites in her abdomen.
In the events/months that followed they did several liver biopsies (Biopsy show Stage 2 Fibrosis) and have found two strictures in the Portal Veins (which they opened by stents) a stricture in the bile duct (also opened by a stent). Despite all this her ascites kept coming back and her overall health worsened. In the start her ascites was red but then changed to white but recently has changed to red again.
In July 2014 she went through a Abdomen Laproscopy to find out the cause of the ascites but the team found nothing. She came out with SBP post surgery which they treated with antibiotics.
Several MRI, CT Scans, Ultrasounds and Cancer Screening Markers tests were conducted but nothing was found.
Her ascites contained high levels of lymph and therefore the doctors suggested we do a Lymph angiogram. The lymph angiogram found a blockage in her lymph vessels. They put her on a fat free diet. Within 2 weeks of the fat free diet her Biliruben started to shoot up. They did an ERCP and found a stenosis in the bile duct and put a stent in there. At this point her ascites had started turning red from white again.
Recently the hematologists have asked for another biopsy and another venogram which was conducted last Friday. The vengoram showed high portal pressure but the biopsy showed Stage 2 Fibrosis and an early evidence of bridging fibrosis.
She has been HCV free for about 18 months. She has had no history of acute rejection.
Questions to the doctors on this forum is (especially Dr Sachiano) what do you think is going on here? Here AST is 60, ALT 30, Biliruben two month ago was 1 but now is ~19.
The hepatologist has maintained her Tac levels at 3 to 4 (0.5 mg ONCE a day).