An Unusual Cause of Elevated Values on Liver Function Tests in a Liver Transplant Patient

Biliary obstruction and rejection are two of the most common causes of abnormal findings on liver function tests (LFTs) in patients who have already undergone liver transplantation. Here we present a post-transplant patient with jaundice. Tests showed that he had no hepatitis B surface antigen before transplantation; he received a core antibody-negative liver. He was not previously vaccinated against hepatitis B, however, and acute hepatitis B was found to be the cause of his increased values on LFTs. His case demonstrates the need to keep a broad differential during laboratory workup of such patients and to vaccinate those patients at risk for acquiring hepatitis B or developing complications.