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Combined liver-kidney transplantation and follow-up in primary hyperoxaluria treatment: report of three cases.
[primary hyperoxaluria type 1]
Primary
hyperoxaluria
type
-
1
(
PH
1
)
is
an
autosomal
recessive
disorder
caused
by
impaired
activity
of
the
hepatic
peroxisomal
alanine-glyoxilate
aminotransferase
,
which
leads
to
end-
stage
renal
disease
(
ESRD
)
and
requires
combined
liver
-kidney
transplantation
(
CLKT
)
.
Herein
,
we
have
reported
3
children
diagnosed
with
PH
1
who
received
CLKT
.
CASE
1
:
A
4
.
5
-
year
-old
boy
with
an
elder
brother
diagnosed
with
PH
1
was
diagnosed
during
family
screening
when
the
sonography
showed
multiple
calculi
.
Within
5
years
he
experienced
flank
pain
,
hematuria
attacks
,
and
anuric
phases
due
to
obstruction
and
received
hemodialysis
(
HD
)
when
ESRD
appeared
.
CLKT
was
performed
from
his
full-match
sister
at
the
age
of
9
.
5
.
He
is
doing
well
at
5
.
5
years
.
CASE
2
:
A
7
-
year
-old
boy
was
admitted
with
polyuria
,
polydypsia
,
and
stomach
pain
with
renal
stones
on
sonography
.
PD
was
instituted
when
serum
creatinine
and
BUN
levels
were
measured
as
high
values
.
At
the
age
of
10
,
CKLT
was
performed
from
his
mother
.
His
liver
and
renal
function
tests
are
well
at
14
months
after
CKLT
.
CASE
3
:
A
2
.
5
-
year
-old
girl
had
attacks
of
dark
urine
without
any
pain
;
renal
stones
were
imaged
on
sonography
.
She
was
diagnosed
with
PH
1
and
operated
on
several
times
due
to
obstruction
.
She
received
peritoneal
dialysis
and
a
cadaveric
CLKT
was
performed
when
she
was
9
years
old
.
At
the
age
of
16
,
she
experienced
chronic
allograft
nephropathy
requiring
HD
and
subsequent
cadaveric
donor
renal
transplantation
at
1
.
5
years
after
initiation
of
HD
.
H
erein
,
we
have
presented
the
favorable
clinical
outcomes
of
patients
with
CKLT
to
indicate
the
validity
of
this
treatment
choice
for
PH
1
.
Diseases
Validation
Diseases presenting
"flank pain"
symptom
primary hyperoxaluria type 1
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