Transplantation in adults with primary hyperoxaluria: single unit experience and treatment algorithm.

Abstract:

BACKGROUND:Kidney transplantation alone in Primary Hyperoxaluria is associated with a high rate of recurrence and in many cases early graft loss. Liver transplantation offers the possibility of correcting the metabolic defect. MATERIAL/METHODS:A retrospective review of five cases of Primary Hyperoxaluria managed at a major transplant unit was performed. RESULTS:The 5 patients had a mean age of 32.2 years (range 28-40) at time of first transplantation. 3 patients had kidney only transplants (one live donor, 2 deceased donor) and 2 had segmental liver followed by delayed kidney transplantation. All 3 kidney alone failed and one is now awaiting a live donor transplant, one underwent kidney alone retransplantation (failed 5 years later) and one had a combined deceased donor liver and kidney transplantation (remains well at 4 years). The 2 segmental liver sequential kidney transplant recipients remain well at 1 year and 3 years. CONCLUSIONS:Combined liver-kidney transplantation may be a better choice as the primary transplant procedure. The indication and timing for pre-emptive liver or liver followed by delayed kidney transplantation remains a matter of debate.

journal_name

Ann Transplant

authors

Malde DJ,Pararajasingam R,Tavakoli A,Campbell B,Riad H,Parrot N,Prasad KR,Augustine T

doi

10.12659/aot.882227

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

111-7

issue

4

eissn

1425-9524

issn

2329-0358

pii

882227

journal_volume

16

pub_type

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