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Transplantation outcomes in primary hyperoxaluria.
[primary hyperoxaluria type 1]
Optimal
transplantation
strategies
are
uncertain
in
primary
hyperoxaluria
(
PH
)
due
to
potential
for
recurrent
oxalosis
.
Outcomes
of
different
transplantation
approaches
were
compared
using
life-table
methods
to
determine
kidney
graft
survival
among
203
patients
in
the
International
Primary
Hyperoxaluria
Registry
.
From
1976
-
2009
,
84
kidney
alone
(
K
)
and
combined
kidney
and
liver
(
K
+
L
)
transplants
were
performed
in
58
patients
.
Among
58
first
kidney
transplants
(
32
K
,
26
K
+
L
)
,
1
-
,
3
-
and
5
-
year
kidney
graft
survival
was
82
%
,
68
%
and
49
%
.
Renal
graft
loss
occurred
in
26
first
transplants
due
to
oxalosis
in
ten
,
chronic
allograft
nephropathy
in
six
,
rejection
in
five
and
other
causes
in
five
.
Delay
in
PH
diagnosis
until
after
transplant
favored
early
graft
loss
(
p
=
0
.
07
)
.
K
+
L
had
better
kidney
graft
outcomes
than
K
with
death-censored
graft
survival
95
%
versus
56
%
at
3
years
(
p
=
0
.
011
)
.
Among
29
year
2000
-
09
first
transplants
(
24
K
+
L
)
,
84
%
were
functioning
at
3
years
compared
to
55
%
of
earlier
transplants
(
p
=
0
.
05
)
.
At
6
.
8
years
after
transplantation
,
46
of
58
patients
are
living
(
43
with
functioning
grafts
)
.
Outcomes
of
transplantation
in
PH
have
improved
over
time
,
with
recent
K
+
L
transplantation
highly
successful
.
Recurrent
oxalosis
accounted
for
a
minority
of
kidney
graft
losses
.
Diseases
Validation
Diseases presenting
"recurrent oxalosis"
symptom
primary hyperoxaluria type 1
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