Clinical Research Directory

Inclusion Criteria: * The patient is ≥ 12 and \< 20 years of age at enrollment. * ≥2.5 years after last liver transplantation. * Guardian's consent, adolescent assent at enrollment. * The patient is prescribed tacrolimus. * The patient's MLVI (SD of tacrolimus) was \> 2 when calculated by the site for a period of 2 years prior to the review date Exclusion Criteria: * The patient has had transplant of an organ other than liver. * The patient is currently listed for any organ transplantation. * The patient is expected to transition to another service (e.g., adult clinic, another * hospital) during the two years of the study. * Pregnant patients. * A temporary exclusion: the patient is not medically stable or was hospitalized for \>48 consecutive hours in the past three months. * Site PI, study PI, or Medical Monitor determines that the patient should not be a candidate for the intervention due to factors that are not covered in the above criteria.