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.

Severe course of primary hyperoxaluria and renal failure after domino hepatic transplantation

ROMAGNOLI, Renato;AMOROSO, Antonio;SALIZZONI, Mauro
2005-01-01

Abstract

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.
2005
Inglese
Esperti anonimi
5
9
2324
2327
4
http://www3.interscience.wiley.com/cgi-bin/fulltext/118717887/PDFSTART
Domino transplant; nephrocalcinosis; nephrolithiasis; orthotopic liver transplantation; primary hyperoxaluria; renal insufficiency
no
2 – prodotto con deroga d’ufficio (SOLO se editore non consente/non ha risposto)
262
9
A. FRANCHELLO; G. PARALUPPI; R. ROMAGNOLI; M. PETRARULO; C. VIALE; A. PACITTI; A. AMOROSO; M. MARANGELLA; M. SALIZZONI
info:eu-repo/semantics/article
reserved
03-CONTRIBUTO IN RIVISTA::03A-Articolo su Rivista
File in questo prodotto:
File Dimensione Formato  
ossalosi domino.pdf

Accesso riservato

Descrizione: Articolo principale
Tipo di file: PDF EDITORIALE
Dimensione 58.54 kB
Formato Adobe PDF
58.54 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/37548
Citazioni
  • ???jsp.display-item.citation.pmc??? 4
  • Scopus 21
  • ???jsp.display-item.citation.isi??? 18
social impact