Demyelinating CNS processes in late post-liver transplant period

In solid organ recipients, post-transplant neurotoxicity of calcineurin inhibitors (CIs) can be manifested by brain and spinal cord demyelination with multiple sclerosis (MS)-like symptoms. Here are presented two case reports of neurological MS-like symptoms in the long-term post-liver transplant period with different underlying causes. CI neurotoxicity may resemble various neurological diseases, including MS. At the same time, liver transplant recipients can develop true MS regardless of the immunosuppressant use. In liver transplant recipients, adequate differential diagnosis of neurological complications avoids unnecessary medications and reverses severe neurological deficits by immunosuppressant conversion.