Abstract
Primary hyperoxaluria type I (PH I) is a rare genetic disorder that leads to end stage renal disease (ESRD) at an early age due to excessive deposition of calcium oxalate in the kidney. Combined liver-kidney transplantation (LKTx) has been advocated as the treatment of choice for patients with PH I who have progressive renal disease. With combined LKTx the risk of early renal failure secondary to oxalate deposition is anticipated. Here we report a patient with PH I who developed ESRD and underwent a combined LKTx. He lost the kidney graft secondary to early recurrence of oxalosis. Repeat kidney transplantation 13 months after the initial procedure was successful. Elevated plasma oxalate levels persisted for a long time following LKTx and lead to further deposition of oxalate in the second kidney graft. Combined LKTx for patients with PH I requires meticulous preparation and very careful post operative management. Sequential liver transplantation followed by kidney transplantation is to be considered for PH I patients who have ESRD and very high oxalate load.
Competing interests: None declared.
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Acknowledgment
The authors acknowledge the use of Saudi Aramco Medical Services organization (SAMSO) facilities for research data used in this article. Opinions expressed in this article are those of the authors and not necessarily of SAMSO. They also thank Gill Rumsby, PhD, at the University College of London, for measuring the activity of the enzyme alanine: glyoxalate aminotransferase and identifying the mutation of the hyperoxaluria gene.
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Communicated by: Verena Peters.
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Alkhunaizi, A.M., Al-Sannaa, N.A., Raslan, W.F. (2011). Hyperoxaluria and Rapid Development of Renal Failure Following a Combined Liver and Kidney Transplantation: Emphasis on Sequential Transplantation. In: JIMD Reports - Case and Research Reports, 2011/3. JIMD Reports, vol 3. Springer, Berlin, Heidelberg. https://doi.org/10.1007/8904_2011_67
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DOI: https://doi.org/10.1007/8904_2011_67
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