title: Cadaveric orthotopic auxiliary split liver transplantation and kidney transplantation: an alternative for type 1 primary hyperoxaluria.
abstract: 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.
authors.affiliation: Baylor Regional Transplant Institute, Dallas, TX, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Onaca
authors.forename: Edmund Q
authors.initials: EQ
authors.lastname: Sanchez
authors.forename: Larry B
authors.initials: LB
authors.lastname: Melton
authors.forename: George J
authors.initials: GJ
authors.lastname: Netto
authors.forename: Karl A
authors.initials: KA
authors.lastname: Glastad
authors.forename: Patriciu A
authors.initials: PA
authors.lastname: Martin
authors.forename: Takehisa
authors.initials: T
authors.lastname: Ueno
authors.forename: Marlon F
authors.initials: MF
authors.lastname: Levy
authors.forename: Robert M
authors.initials: RM
authors.lastname: Goldstein
authors.forename: Goran B
authors.initials: GB
authors.lastname: Klintmalm
mesh_terms: 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
chemical_list: D010070:Oxalates; D000637:Transaminases; C019635:Alanine-glyoxylate transaminase