Reversal of oxalosis cardiomyopathy after combined liver and kidney transplantation.
Few data have been published on the course of oxalosis cardiomyopathy after combined liver and kidney transplantation in hyperoxaluria patients with myocardial involvement. We report the case of a primary hyperoxaluria type 1 patient with renal failure who developed end-stage cardiomyopathy. Left venticulography showed severe diffuse hypokinesia and left ventricular ejection fraction was calculated at 12%. Endomyocardial biopsy demonstrated platelike calcium oxalate crystals within the myocardium and the connective tissue, and mild perivascular fibrosis. The patient was first considered for combined liver-heart-kidney transplantation, but as his cardiac function improved slightly with an intensive dialysis program, combined liver and kidney transplantation was performed. Normal cardiac function was demonstrated at 1-year follow-up, and comparative endomyocardial biopsy showed regression of the myocardial oxalate deposits. This case adds stronger clinical, hemodynamic, and histopathological evidence that severe oxalosis cardiomyopathy may be reversed after combined liver and kidney transplantation.
Detry
Olivier
O
Department of Surgery and Transplantation, University Hospital of Liège, CHU Sart Tilman B35, 4000 Liège, Belgium. Oli.Detry@chu.ulg.ac.be
Honoré
Pierre
P
DeRoover
Arnaud
A
Trimeche
Mounir
M
Demoulin
Jean-Claude
JC
Beaujean
Marianne
M
Moonen
Martial
M
Godon
Jean-Pierre
JP
Boniver
Jacques
J
Jacquet
Nicolas
N
Meurisse
Michel
M
D000328:Adult; D009202:Cardiomyopathies / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D006960:Hyperoxaluria, Primary / Q000209:etiology* / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D006435:Renal Dialysis / Q000379:methods