Chronic rejection of liver graft is an insidious process. Major immunosuppression medications such as tacrolimus, cyclosporin, and sirolimus have dose-related toxicity and narrow therapeutic windows. Certain drugs can affect metabolism of calcineurin inhibitors. Primary care physicians should be vigilant for any unusual opportunistic infection in liver transplant recipients. The quality of life of liver transplant recipients is an important aspect of care by primary care physicians. Alcohol relapse and possibility of depression in liver transplant recipients should be a continuous concern for primary care physicians. This article provides a guideline for the care of liver transplant recipients.
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