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Native portal vein embolization for persistent hyperoxaluria following kidney and auxiliary partial liver transplantation.
[primary hyperoxaluria type 1]
Type
1
primary
hyperoxaluria
(
PH
1
)
causes
renal
failure
,
for
which
isolated
kidney
transplantation
(
KT
)
is
usually
unsuccessful
treatment
due
to
early
oxalate
stone
recurrence
.
Although
hepatectomy
and
liver
transplantation
(
LT
)
corrects
PH
1
enzymatic
defect
,
simultaneous
auxiliary
partial
liver
transplantation
(
APLT
)
and
KT
have
been
suggested
as
an
alternative
approach
.
APLT
advantages
include
preservation
of
the
donor
pool
and
retention
of
native
liver
function
in
the
event
of
liver
graft
loss
.
However
,
APLT
relative
mass
may
be
inadequate
to
correct
the
defect
.
We
here
report
the
first
case
of
native
portal
vein
embolization
(
PVE
)
to
increase
APLT
to
native
liver
mass
ratio
(
APLT
/
NLM-R
)
.
Following
initial
combined
APLT-KT
,
both
allografts
functioned
well
,
but
oxalate
plasma
levels
did
not
normalize
.
We
postulated
the
inadequate
APLT
/
NLM-R
could
be
corrected
by
trans-
hepatic
native
PVE
.
The
resulting
increased
APLT
/
NLM-R
decreased
serum
oxalate
to
normal
levels
within
1
month
following
PVE
.
We
conclude
that
persistently
elevated
oxalate
levels
after
combined
APLT-KT
for
PH
1
treatment
,
results
from
inadequate
relative
functional
capacity
.
This
can
be
reversed
by
partial
native
PVE
to
decrease
portal
flow
to
the
native
liver
.
This
approach
might
be
applicable
to
other
scenarios
where
partial
grafts
have
been
transplanted
to
replace
native
liver
function
.
Diseases
Validation
Diseases presenting
"first case"
symptom
achondroplasia
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
alpha-thalassemia
aniridia
aromatase deficiency
canavan disease
carcinoma of the gallbladder
child syndrome
cholangiocarcinoma
classical phenylketonuria
coats disease
cohen syndrome
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
esophageal adenocarcinoma
esophageal carcinoma
fabry disease
familial mediterranean fever
focal myositis
gm1 gangliosidosis
harlequin ichthyosis
hodgkin lymphoma, classical
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
krabbe disease
lamellar ichthyosis
legionellosis
liposarcoma
locked-in syndrome
malignant atrophic papulosis
monosomy 21
neonatal adrenoleukodystrophy
oculocutaneous albinism
omenn syndrome
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
systemic capillary leak syndrome
thoracic outlet syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
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