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Two‐step transplantation for primary hyperoxaluria: Cadaveric liver followed by living donor related kidney transplantation
Author(s) -
Malla Ivone,
Lysy Philippe A.,
Godefroid Nathalie,
Smets Françoise,
Malaise Jaques,
Reding Raymond,
Sokal Etienne M.
Publication year - 2009
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2008.01049.x
Subject(s) - medicine , primary hyperoxaluria , transplantation , kidney , urinary system , acute tubular necrosis , oxalate , surgery , liver transplantation , kidney disease , urology , kidney transplantation , cadaveric spasm , urinary leakage , nephrology , gastroenterology , chemistry , organic chemistry
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.