Early renal failure after domino hepatic transplantation using the liver from a compound heterozygous patient with primary hyperoxaluria.

Farese, Stefan; Trost, Nicolas; Candinas, Daniel; Huynh-Do, Uyen (2005). Early renal failure after domino hepatic transplantation using the liver from a compound heterozygous patient with primary hyperoxaluria. Nephrology, dialysis, transplantation, 20(11), pp. 2557-2560. Oxford University Press 10.1093/ndt/gfi019

	Text Nephrol. Dial. Transplant.-2005-Farese-2557-60.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (81kB)
Preview	Text gfi019.pdf - Other Available under License Publisher holds Copyright. Download (82kB) | Preview

BACKGROUND

To cover the shortage of cadaveric organs, new approaches to expand the donor pool are needed. Here we report on a case of domino liver transplantation (DLT) using an organ harvested from a compound heterozygous patient with primary hyperoxaluria (PHO), who underwent combined liver and kidney transplantation. The DLT recipient developed early renal failure with oxaluria. The time to the progression to oxalosis with renal failure in such situations is unknown, but, based on animal data, we hypothesize that calcineurin inhibitors may play a detrimental role.

METHODS

A cadaveric liver and kidney transplantation was performed in a 52-year-old male with PHO. His liver was used for a 64-year-old patient with a non-resectable, but limited cholangiocarcinoma.

RESULTS

While the course of the PHO donor was uneventful, in the DLT recipient early post-operative, dialysis-dependent renal failure with hyperoxaluria developed. Histology of a kidney biopsy revealed massive calcium oxalate crystal deposition as the leading aetiological cause.

CONCLUSIONS

DLT using PHO organs for marginal recipients represents a possible therapeutic approach regarding graft function of the liver. However, it may negatively alter the renal outcome of the recipient in an unpredictable manner, especially with concomitant use of cyclosporin. Therefore, we suggest that, although DLT should be promoted, PHO organs are better excluded from such procedures.

Interest & Impact

Downloads

133 since deposited on 17 Jun 2015
6 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item