Inclusion Criteria:  Adults aged 18 - 65 years. Patients suffering from end stage liver disease (ESLD) with any etiology listed on waiting list and accepting to volunteer in the study with the informed consent. Patients not suffering from any active infection at the start of the study.  Exclusion Criteria:  Patients with poorly controlled autoimmune disease on immunosuppression before transplantation. Patients who undergo combined kidney-liver transplantation. Patients with severe renal insufficiency (creatinine clearance <50 ml/min). Patients with intestinal obstruction (ileus). Patients with cerebral disorders with danger of aspiration. Patients with roux en Y-anastomosis. Patients with cystic fibrosis. Retransplantation.