I had a olt in 8/98 secondarily to hepp. C infection. The t-plant was done at johns hopkins and the complications included rejection, cmv and reinfection. I tried to take peg/ribaviron last year but was too sick to continue. My last biopsy showed minimal inflamation consistent with hep c. Also, no aggressive behavior of the hep c. My meds are tacrolimus 3.5 mg twice a day. I am concerned with my kidney function at this time due to an increasing creatinine, now 1.5, and 24 hr. creat. at 65%. No protein. I wonder if changing to sirolimus would be beneficial and should I wait for a less toxic regimen for the hep c. Thank you for your kind consideration.
 
PS the hep c was from an exposure to a patient 17 years ago. Type 1b. viral load 1,400,000.
 

id' keep a close eye on liver biopsies if you arent' treated for HCV , but that biopsy is reassuring. we do not use sirolimus for livers at our center, but you might discuss that with your surgeons, as some centers do. you might consider lower dose peg +/- riba to suppress the hcv at a dose you can tolerate (we have done this with a number of our pts.), but i agree that waiting for a less toxic regimen makes sense.