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Re: Transplant evaluation

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Liz,

It is my understanding, from what and I have been told, that in the

majority of cases PSC will develop into bile duct cancer. We were also told

that if this happens they will not consider him for a transplant, because

once the cancer is there, it is likely to spread and doing a transplant would

be useless because it may have already spread to other areas or affected the

main hepatic duct. I hope this doesn't happen to anyone, but it did happen

to Walter Payton. Hope I didn't upset you with that tidbit, if I am

mistaken, please let me know.

Spring

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Hi Spring,

No, you didn't upset me with your reply. I more or less am prepared for

anything these days. I just wanted to get some feedback from those in the

group that are much more knowledgable than myself as far as transplant issues

go.

I am so sorry to hear about your husband's past medical history. As if that

weren't enough for one person to go through. I guess we never know what is

in the cards for us. Anyway, welcome to the group. I hope you get as much

out of being a member as I do.

Liz

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Spring,

I believe you are mistaken. The cancer rate (Cholangiocarcinoma) for PSC

patients is between 7-12%. Most of us will not get cancer.

Adam

In a message dated 1/6/00 6:44:38 PM Pacific Standard Time,

SPRINGREED@... writes:

It is my understanding, from what and I have been told, that in the

majority of cases PSC will develop into bile duct cancer. We were also told

that if this happens they will not consider him for a transplant, because

once the cancer is there, it is likely to spread and doing a transplant

would

be useless because it may have already spread to other areas or affected the

main hepatic duct. I hope this doesn't happen to anyone, but it did happen

to Walter Payton. Hope I didn't upset you with that tidbit, if I am

mistaken, please let me know.

Spring

>>

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Spring,

I believe you are mistaken. The cancer rate (Cholangiocarcinoma) for PSC

patients is between 7-12%. Most of us will not get cancer.

Adam

In a message dated 1/6/00 6:44:38 PM Pacific Standard Time,

SPRINGREED@... writes:

It is my understanding, from what and I have been told, that in the

majority of cases PSC will develop into bile duct cancer. We were also told

that if this happens they will not consider him for a transplant, because

once the cancer is there, it is likely to spread and doing a transplant

would

be useless because it may have already spread to other areas or affected the

main hepatic duct. I hope this doesn't happen to anyone, but it did happen

to Walter Payton. Hope I didn't upset you with that tidbit, if I am

mistaken, please let me know.

Spring

>>

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The estimated lifetime risk of bile duct cancer in PSC patients is estimated

to be about 10%. That's a big number if you are one of those 10% like

Walter Payton. But it's not the majority.

Anyway the problem with this cancer is by the time it is detected it usually

has spread which does rule out transplantation. Immune supression can

make the cancer grow quickly.

Thanks Roy T.

Re: Transplant evaluation

> Liz,

>

> It is my understanding, from what and I have been told, that in

the

> majority of cases PSC will develop into bile duct cancer. We were also

told

> that if this happens they will not consider him for a transplant, because

> once the cancer is there, it is likely to spread and doing a transplant

would

> be useless because it may have already spread to other areas or affected

the

> main hepatic duct. I hope this doesn't happen to anyone, but it did

happen

> to Walter Payton. Hope I didn't upset you with that tidbit, if I am

> mistaken, please let me know.

>

> Spring

>

> ------------------------------------------------------------------------

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>

>

>

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Aubrey,

I had an MRCP one year ago, after itching led to discovery of elevated LFTs

through blood tests, and after ultrasound showed nothing abnormal. My

understanding is that MRCP is a variation on the standard MRI, one that is

focused on the liver. My gastroenterologist, who had consulted a prominent

hepatologist, was operating under the assumption that an MRCP would reveal

PSC (his preliminary diagnosis based on symptology), but in fact my MRCP

proved negative. Then I had a liver biopsy, which was suggestive of PSC --

but apparently biopsy is not conclusively diagnostic. My doctor strongly

urged me to have an ERCP next, to prove I had PSC, but I decided I had enough

proof, and because I was (and hopefully still am a year later) in an early

stage of the disease there was very little chance that the ERCP could be

therapeutic (i.e., dilation of ducts). I consulted 2 other doctors, who

agreed with my reasoning. -- Erwin

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