The study aimed to assess the possibility of Ramadan fasting and to start protocol of adapting immunosupression regiment and scheduled follow up for patients wishing to fast after liver transplantation (LT).

Very limited data in the literature about how to apply Ramadan fasting in the post liver transplant setting. The timing of Ramadan is changeable according to the lunar year and according to time of down and sunset in each country. In Egypt, for example, Ramadan fasting this year started 17th of May and finished 14th June with average fasting hours of 15-16 hours The study aimed to assess the possibility of Ramadan fasting and to start protocol of adapting immunosupression regiment and scheduled follow up for patients wishing to fast after LT.This prospective study included 45 recipients who underwent LT at Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.

Inclusion Criteria:

• • Recipients completed their first year after LDLT

  • Normal liver and renal functions at least in the last 3 months before fasting
  • No reported rejection episodes in the last 6 months before the study
  • Recipients wishing to fast Ramadan
  • Informed consent about the study

Exclusion Criteria:

• • First year of LDLT

  • Recipients transplanted for Budd Chiari syndrome
  • Recipients with vascular stents (hepatic artery , portal vein or hepatic vein stents) requiring long life anticoagulation
  • Creatinine clearance <60 ml/min or serum creatinine >1.5 mg/dl at time of initial enrolment in the study.

patients underwent Living donor liver transplantation