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Early renal failure after domino liver transplantation using organs from donors with primary hyperoxaluria type 1.
[primary hyperoxaluria type 1]
Organ
shortage
is
responsible
for
high
mortality
rates
of
patients
awaiting
liver
transplantation
(
LT
)
.
Domino
transplantation
has
had
reported
success
in
patients
with
metabolic
disorders
.
Primary
hyperoxaluria
type
1
(
PH
1
)
is
a
rare
metabolic
disorder
.
There
are
a
few
case
reports
that
suggest
that
PH
1
livers
originating
from
donors
that
have
undergone
combined
liver
-kidney
transplantation
can
be
successfully
used
for
domino
transplantation
.
In
the
last
decade
,
five
patients
received
a
domino
liver
transplant
from
patients
with
PH
1
in
the
EUROTRANSPLANT
region
.
In
this
study
,
we
report
the
clinical
course
and
outcome
of
these
five
patients
who
were
received
a
domino
graft
transplant
.
All
patients
,
with
the
exception
of
one
,
suffered
from
multifocal
hepatocellular
carcinoma
and
underwent
domino
LT
from
patients
undergoing
combined
liver
-kidney
transplantation
for
PH
1
.
Within
the
first
4
weeks
,
all
the
domino
recipients
developed
dialysis-dependent
kidney
failure
despite
good
liver
function
.
Four
of
the
five
patients
died
.
The
only
survivor
underwent
retransplantation
due
to
hepatic
artery
thrombosis
.
Twenty
months
after
transplantation
,
this
patient
is
doing
well
and
has
had
no
recurrence
of
hepatocellular
carcinoma
.
Domino
LT
using
donors
with
PH
1
results
in
early
renal
failure
and
can
not
be
recommended
for
transplantation
unless
preventive
strategies
have
been
identified
.