Trasplante hepatorrenal simultáneo en pacientes adultos con hiperoxaluria primariaExperiencia del Hospital Universitario 12 de Octubre
- Javier Martínez Caballero 1
- Alberto A. Marcacuzco Quinto 1
- Iago Justo Alonso 1
- Oana Anisa Nutu 1
- Alejandro Manrique Municio 1
- Jorge Calvo Pulido 1
- Félix Cambra Molero 1
- Óscar Caso 1
- Luis Carlos Jiménez Romero 1
- 1 Hospital Universitario 12 de Octubre. Madrid
ISSN: 2340-416, 1130-0108
Any de publicació: 2018
Volum: 110
Número: 2
Pàgines: 82-87
Tipus: Article
Altres publicacions en: Revista Española de Enfermedades Digestivas
Resum
Primary hyperoxaluria (PH) is a metabolic liver disease with an autosomal recessive inheritance that results in oxalate overproduction that cannot be metabolized by the liver. Urinary excretion of oxalate results in lithiasis and nephrocalcinosis leading to a progressive loss of renal function that often requires renal replacement therapy despite medical treatment. Type 1 PH is the most common form and is due to a deficiency in the alanine-glycolate aminotransferase enzyme found in hepatic peroxisomes. Therefore, a liver-kidney simultaneous transplant (LKST) is the definitive treatment for end-stage renal disease (ESRD) patients. However, some studies suggest that the morbidity and mortality rates are greater when this procedure is performed instead of only a kidney transplant (IKT). Herein, we report five patients with PH and a mean glomerular filtration rate of 20.2 ± 1.3 ml/min/1.73 m2 who received a LKST between 1999 and 2015 at the Hospital Universitario 12 de Octubre. Recurrence and liver or kidney graft loss was not observed during the postoperative period and only one case of late acute rejection without graft loss was diagnosed. The recipient survival rate was 100% with a median follow up of 84 months. As LKST is a curative and safe procedure with a low mortality and high survival rate, it must be considered as the treatment of choice in adults with HP and ESRD