Monday, March 18, 2013 6:44 PM
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Stephen Lovatt
Was reading a couple of articles ( see below ) and I just cant get my head around these things Just wondering if anybody else has an opinion on why a liver transplant can result in Huge decrease in EDSS and solid disease stablization ? The articles don't really even speculate why ? see these two articles Abstract: The Canadian Journal of Neurological Sciences Issue: Volume 31, Number 4 / November 2004
Pages: 539 - 541 Background: The effect of liver transplantation on pre-existing multiple sclerosis (MS) has never been reported. We report the three year post-transplant neurological outcome of a patient with MS. Case report: A Caucasian woman with MS received an urgent liver transplant for fulminant liver failure at the age of 59. Her Extended Disability Scale Score (EDSS) pretransplant was 5.0 and clinically she had cerebellar and brainstem dysfunction. Post-transplant immunosuppression consisted of tacrolimus, mycophenolate mofetil and tapering corticosteroids that were discontinued after 1.5 years. Post-transplant her EDSS decreased to 2.0 and after three years she is clinically asymptomatic with only very mild dysarthria on neurologic examination. Long-term maintenance immunosuppression consists of low dose tacrolimus. Conclusions: Combination immunosuppression with tacrolimus may have a beneficial effect on MS although an effect of donor allograft itself can not be excluded. also see article Transplant International Volume 20 Issue 12, Pages 1077 - 1079 Improvement of multiple sclerosis on tacrolimus plus mycophenolate mofetil after liver transplantation Clinical improvement of multiple sclerosis in a patient requiring liver transplantation for acute liver failure following interferon-ß therapy
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