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Severe Course of Primary Hyperoxaluria and Renal Failure After Domino Hepatic Transplantation
Author(s) -
Franchello Alessandro,
Paraluppi Gianluca,
Romagnoli Renato,
Petrarulo Michele,
Vitale Corrado,
Pacitti Alfonso,
Amoroso Antonio,
Marangella Martino,
Salizzoni Mauro
Publication year - 2005
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2005.01014.x
Subject(s) - medicine , primary hyperoxaluria , liver transplantation , domino , transplantation , cirrhosis , kidney , renal function , urology , gastroenterology , surgery , biochemistry , chemistry , catalysis
We report herein a domino orthotopic liver transplantation (LT), from a 38‐year‐old woman undergoing liver‐kidney transplantation (LKT) for primary hyperoxaluria type I (PH1) to a recipient with cirrhosis and hepatocellular carcinoma. Delayed onset of PH1 and renal failure and 10% residual alanine‐glyoxylate aminotransferase (AGT) activity in domino liver justified its use for domino procedure. The clinical course after LKT was similar to that described in other series, including ours. Renal function started promptly and maintained despite sustained hyperoxaluria from dissolution of oxalotic deposits. Conversely, the domino recipient manifested severe hyperoxaluria and developed nephrolithiasis and renal insufficiency with rapid progression over 2 months. A new LT resulted in slow decrease of oxaluria and improvement of renal function. Therefore, PH1 behaved quite differently in these two patients, leading us to conclude that domino LT using livers from PH1 patients should be considered very carefully, only as a bridge to definitive LT in recipients with critical clinical conditions.