Help from Korea (Jaundice)

[daniellim]

Hello, I am translating on behalf of my friend. I will do the best that I can to write this up in the most clear manner. Please excuse any grammar.

Translation:

My father underwent hepatocirrhosis liver transplant 10 years ago but the his health is getting worse. He is showing signs of (bulwark lethargy)…lack of defender and high concentration of jaundiced alcoholic liver failure. He recently had another liver transplant and shows that the liver is close to stable (normal) however, jaundice figures are not going under 37.

There is a slight sign of rejection after each ptbd treatment. The hospital has no idea why the treatment or the level of jaundice is not falling. We have no more resources here in korea. What can be the reasoning behind the Jaundice level not falling? His health and stamina is also deteriorating.

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I tried my best to be concise. Please help


Here is the original text just in case someone can read korean

10년전 간경화로 이식수술하고 계속 상태가 안좋다가 간성혼수와 높은 황달알콜성간경화로 재이식후 간수치는 정상에 가까우나 황달수치가 37로 떨어지지않고있습니다
약간의 거부반응으로 아트감 치료후 ptbd시술
계속 황달이 떨어지지않는 이유는 무엇인가요?
체력도 너무 안좋으십니다.

[Thomas D Schiano, MD]

Ok thanks

[daniellim]

Thank you, I have relayed the message to my friend. Ill let you know what happens next.

Daniel

[Thomas D Schiano, MD]

he may have developed chronic rejection which as no treatment aside from optimization of prograf--if he has not had a recent liver biopsy it should be performed to help guide ongoing/future therapy

[hp00]

I may add some, based on from Korean blog site.
He had a deceased Ltx on 1/9/14.  He was hospitalized in the end of Feb because of high Billlirubin.  Dr. found 2 kinds of rejection (not sure whether he had a Biopsy, my guess is he did) and had atgam for 1 week.  Billirubin was still high, so he had PTBD in the end of March.  Billirubin is still high at 37.

[daniellim]

Ill ask about the biopsy…in that case, do you suggest another liver transplant? Is there any other possibilities? Thank you for taking your time to answer this question.

[Thomas D Schiano, MD]

it could be rejection of the liver--I presume that these were live donor transplants.  he presumably had a liver biopsy performed which could be a clue as to what is going on.