*Purpose: Fibrosing cholestatic hepatitis is often fatal post renal transplantation. we report a case of successful treatment of FCH and complete recovery

*Methods: A 53 year old male presented 2 year post renal transplant (live donor being spouse) with jaundice, fever, itching and altered sensorium

*Results: he had undergone renal transplantation in 2014 with normal graft functions presented with total bilirubin of 12.3mg/dl (direct 10.8) GGTP 1627 IU/L. HbsAg and Hepatitis B core IgM was negative. Hepatitis C RNA was positive with high titre and was reported as genotype 1 (pretransplant being negative). liver biopsy revealed cholestasis special stains revealed fibrous portal expansion and periportal fibrosis. he was treated with anti – encephalopathy measures, sofosbuvir/ledipasvir as per protocol. his jaundice resolved and he was discharged in few weeks. it is 3 years post treatment, he continues to be healthy with normal renal and liver functions. with HCV being negative.

*Conclusions: this is one of the rare patients to survive post renal transplantation FCH secondary to HCV and successfully treated with newer DAA ( direct antiviral agents). sofosbuvir/ledipasvir has been available only recently, and he has has been one of the first to receive in 2016. high index of suspicion and appropriate DAA saved this patient from imminent death

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