Two-step transplantation for primary hyperoxaluria: cadaveric liver followed by living donor related kidney transplantation.
In PH, PLTX, although ideal in theory, is rarely achieved. Patients usually have reached end-stage kidney disease while requiring combined liver and kidney transplantation. In this combined procedure, the sudden high oxalates mobilization from blood and tissue stores jeopardizes the success of the kidney graft, with a high risk of post-transplant early kidney necrosis or chronic graft damage. Here, we report the case of a three-yr-old girl with PH and ESRF in whom we performed sequentially deceased donor liver transplantation followed four months later by living donor kidney transplant, after normalization of blood oxalate levels and improvement of urinary oxalate output. After this two-step transplantation, our patient showed normalization of renal function with good urinary output and maintained normal blood oxalate levels. This strategy seems to be a reasonable approach in order to avoid acute renal tubular injury because of oxalate excretion in these patients.
Malla
Ivone
I
Département de Pédiatrie, Hépatologie et transplantation hépatique pédiatrique, Université Catholique de Louvain & Cliniques Universitaires Saint Luc, Brussels, Belgium.
Lysy
Philippe A
PA
Godefroid
Nathalie
N
Smets
Françoise
F
Malaise
Jaques
J
Reding
Raymond
R
Sokal
Etienne M
EM
D002102:Cadaver; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D006960:Hyperoxaluria, Primary / Q000628:therapy*; D007674:Kidney Diseases / Q000628:therapy; D016030:Kidney Transplantation / Q000379:methods*; D008107:Liver Diseases / Q000628:therapy; D016031:Liver Transplantation / Q000379:methods*; D010070:Oxalates / Q000097:blood / Q000652:urine; D012306:Risk; D016896:Treatment Outcome
D010070:Oxalates