Inclusion Criteria:  Adults aged 18 years or older Recipients of a first-time liver transplant eGFR more than 30 ml/min on the day of tacrolimus initiation All patients who are eligible to initiate Tacrolimus within 7 days post-liver transplant Informed consent  Exclusion Criteria:  Recipients of prior organ transplant Need for hemodialysis either prior or following liver transplantation Recipients of living donor liver or split deceased donor liver allografts Recipients of combined liver/kidney transplants Recipients receiving liver allografts from donors with HCV viremia (detected through nucleic acid testing or other means) Patients with a history of tremor prior to transplantation including essential tremors, Parkinson's or Parkinsonian syndromes Patients receiving concomitant medications known to induce tremors such as dopamine blocking agents Baseline TSH, T3, T4 indicating hyperthyroidism