Cadaveric orthotopic auxiliary split liver transplantation and kidney transplantation: an alternative for type 1 primary hyperoxaluria.
Liver transplantation (LTX) corrects the enzymatic defect responsible for type 1 primary hyperoxaluria (PH1). It has been advocated in combination with kidney transplantation (KTX) in patients with renal failure from PH1 because KTX alone can result in early graft loss. A 58-year-old male patient with PH1 on hemodialysis underwent resection of the left lateral segment of the liver followed by orthotopic auxiliary left lateral segment liver transplantation and kidney transplantation from a deceased donor. The serum oxalate dropped from 34.8 micromol/L before transplant to 3.6-8.3 in the first months posttransplant to <1 micromol/L (normal range 0.4-3.0). One year after posttransplant, the patient has an iothalamate glomerular filtration rate of 58 ml/min. Orthotopic auxiliary LTX is an alternative to whole LTX in PH1. By using a split deceased donor liver, it does not deprive the donor pool and protects the recipient from liver failure in case of graft loss.
Onaca
Nicholas
N
Baylor Regional Transplant Institute, Dallas, TX, USA.
Sanchez
Edmund Q
EQ
Melton
Larry B
LB
Netto
George J
GJ
Glastad
Karl A
KA
Martin
Patriciu A
PA
Ueno
Takehisa
T
Levy
Marlon F
MF
Goldstein
Robert M
RM
Klintmalm
Goran B
GB
D002102:Cadaver; D004252:DNA Mutational Analysis; D005919:Glomerular Filtration Rate; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D006960:Hyperoxaluria, Primary / Q000628:therapy*; D016030:Kidney Transplantation / Q000379:methods*; D008099:Liver / Q000033:anatomy & histology / Q000473:pathology; D016031:Liver Transplantation / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010070:Oxalates / Q000097:blood*; D006435:Renal Dialysis; D013997:Time Factors; D014019:Tissue Donors; D000637:Transaminases / Q000235:genetics
D010070:Oxalates; D000637:Transaminases; C019635:Alanine-glyoxylate transaminase