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: Nicholas Onaca, Edmund Q Sanchez, Larry B Melton, George J Netto, Karl A Glastad, Patriciu A Martin, Takehisa Ueno, Marlon F Levy, Robert M Goldstein, Goran B Klintmalm
• Journal: Transplantation (Transplantation) Vol. 80 Issue 3 Pg. 421-4 (Aug 15 2005) ISSN: 0041-1337 [Print] United States
• PMID: 16082341 (Publication Type: Case Reports, Journal Article)

Chemical References

• Oxalates
• Transaminases
• Alanine-glyoxylate transaminase

Topics

• Cadaver
• DNA Mutational Analysis
• Glomerular Filtration Rate
• Graft Rejection
• Graft Survival
• Humans
• Hyperoxaluria, Primary (therapy)
• Kidney Transplantation (methods)
• Liver (anatomy & histology, pathology)
• Liver Transplantation (methods)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Oxalates (blood)
• Renal Dialysis
• Time Factors
• Tissue Donors
• Transaminases (genetics)