Extremely high triglycerides, GGT, billirubin post bone marrow transplant

[wang082]

My 4-year old daughter had matched sibling cord blood transplant ~5 months ago and she developed level II gut GVHD 2 month after transplant. In the past two months, she had several fungus & bacteria & unknown blood infections, as well as a recent respiratory failure which required ossilating ventilor for several days.

When she just recovered from the respriratory failure, her liver function suddenly deteriorated dramatically in the past two weeks: triglycerides (2730), GGT (5482), Bilirubin total (17.9), ALT/AST (173/228). Luckily, her pancreas seems doing OK so far.

She has been on TPN for > 5 months and other meds: CSA, steroid, caspofugin, voriconazole, ganciclorovir, acyclovir and many antibiotics for extended periods.

Ultrasound shows no evidence of hepatic veno-occlusive desease or biliary obstruction. It does suggest continued gallbladder sludge, but without cholecystitis.

The removal TPN (~ 1 week) does not yield noticable improvement. CSA was changed to MMF yesterday. It's prabobly too soon to see its impact. The low likelyhood of having liver GVHD does not warrant a liver biopsy at this point. I was told there is no safe and effective medicine available to lower down triglycerides level and help heal liver.

Does anyone have any previous experience with this? Any ideas are welcome and highly appreciated.

[Hawaii Bill]

Aloha,

My trigs were 289 in May 2011, and I got them down to 116 in March 2012. My total cholesterol was 162, and it came down to 108. HDL is still low, and LDL was already well below suggested levels.

Part of the change MAY be a result of increased exercise, but I discount that because my HDL cholesterol was still too low, and it should have gone up as a result of the exercise.

The other change was taking a annato tocotrienol supplement every night, as recommended by my nutritionist. Tocotrienols are a different version of Vitamin E, apparently more bioavailable, so they can be more effective for many people than regular Vitamin E.

Others on this forum may have preferred vendors, but my nutritionist recommended Designs for Health. Here is an article:

http://www.cristianapaul.com/DFH%20P...cotrienols.pdf

NOTE that there is a concern about platelets...

Bill