This is a record of my medical challenges from
10 to 24 October -> 30 October -> 5 November -> 12 November 2025.
After a liver panel test done on the 13th of October, my results showed signs of liver rejection. This was alerted by my keen-eyed medical coordinator, Beverly. She consulted Dr. Terrence Tan, whom I came to see as a competent and conscientious doctor, who quickly assessed and followed up on my situation. I was immediately told by Beverly that Dr. Terrence advised me to report to the A&E immediately for admission.
I reported to the SGH A&E one day later on 14 October. This event kicks off a series of processes in my mind—observation of my symptoms; assessments and evaluations of my medical conditions; interpretations and understanding of what the test data means; gathering my thoughts after the interpretations; and finally reflecting and musing on the analysis and its implications.
In the first 2 to 3 weeks of October, my results show that my liver was struggling to perform, and there was a parallel deterioration of my kidney function. It suggests the possibility of a rejection or medication toxicity.
My liver/kidney trend from 10 October to 12 November 2025 is as follows:
1. Liver Trend
From the liver panel test done on the 13th of Oct, my liver enzymes (ALT, AST, GGT, ALP, and bilirubin) reveal the following:
- 10 Oct to mid-Oct:
- ALT and AST were very high (≈160–180), bilirubin was also up, and GGT was high. All these numbers painted a picture of liver inflammation.
- Late Oct (23–29 Oct):
- ALT/AST dropped drastically (into the 70s / 50–60s range). With bilirubin coming down close to normal. The ALP stayed in the normal range. But GGT stayed high (around 110–140).
- 5 Nov to 12 Nov:
- ALT: 71 → 70 (no change, only mildly above normal).
- AST: 60 → 57 (stable, but mildly high).
- ALP: 89 → 82 (in the normal range).
- Bilirubin: 37 → 41 (mildly high but much better than that of early October).
- GGT: 154 → 178 (still high and creeping up).
As for the production of vital blood proteins like albumin and blood clotting factors, the albumin & total protein seem a bit low but stable and slightly better (TP 63→68, albumin 32→34).
• INR/PT is in a safe range and not drifting up.
• Platelets: low (65 on 10 Oct) but have been rising slowly by late Oct. It was 87 on 12 Nov.
Overall, I could see a big improvement in my liver condition as compared to that of early October. Right now, it is a mild and stable enzyme elevation. Based on the 12 Nov test results, there is no sign of a new sudden rejection. The main abnormality is the persistently high GGT, which may reflect bile-duct irritation or medications.
2. Kidney Trend
Date | Urea (mmol/L) | Creatinine (µmol/L) | eGFR (mL/min/1.73 m²) | Bicarbonate |
10 Oct | 7.0 | 111 | 58 | 28.8 |
29 Oct | 10.5 | 129 | 48 | 28 |
5 Nov | 12.7 | 126 | 50 | – |
12 Nov | 12.7 | 126 | 50 | 26.9 |
My kidney numbers are as follows:
• From 10 Oct to late Oct, there was a worsening in my kidney functions. My creatinine rose from 111 to 129, eGFR fell from 58 to the high 40s, and urea went up.
• From late Oct → 5 Nov → 12 Nov, the values are fairly stable (creatinine ~125–130, eGFR ~50, urea ~12–13).
• Bicarbonate has stayed normal, which is reassuring.
Overall, for my kidney, I could see that I am sitting on CKD stage 3a, with a mild decline compared with 10 Oct, but there is no rapid deterioration over the last 2–3 weeks. This pattern is consistent with chronic, stable kidney impairment, likely caused by tacrolimus, rather than an acute crisis.
3. Summary
• Liver: The liver panel readings, in particular the enzymes, show improvement from a significant flare in early October. Right now, my liver has stabilized with mild abnormalities, and the graft function overall looks reasonably good. However, a persistent high GGT that needs ongoing follow-up but no obvious new damage between 5 and 12 Nov.
• Kidneys: The later results from the kidney panel, compared with that of 10 Oct, quite clearly show that my kidney function is deteriorating. But from late Oct through 12 Nov, the numbers look stable rather than steadily falling.
Put it simply, for now, based on my lab test results, my liver recovery looks encouraging, and my kidney function, while reduced, appears stable over the last few weeks—not in free fall.
Afternote: I went for my liver team appointment on the 13th of November. The team was led by Dr. Thinesh. In his review of my lab results, he indicated that my FK level appears high at 8.6 (not at trough level) when my prescribed Advagraf is at a low of 1 mg. He asked whether I mistakenly took my Advagraf before the test. I assured him that I took my Advagraf after my blood test, and I have a daily log to show.
He also mentioned the possibility of an ongoing virus during the period. And has followed up with another round of blood tests (11 tubes) on the same day.
