Use of thromboelastography and hydroelectrolytic management in a child with chronic renal insufficiency submitted to liver transplantation secondary to type 1 primary hyperoxaluria

Anesthesia Management of a Deceased Cadaveric-Donor Combined Liver and Kidney Transplant for Primary Hyperoxaluria Type 1: Report of a Case

Primary hyperoxaluria type 1 is an autosomal recessive disorder that is responsible for the overproduction of oxalate and has an incidence of 1 in 120 000 live births. Indications for combined liver and kidney transplant are still debated. However, combined liver and kidney transplant is preferred in various conditions, including primary hyperoxaluria, liver-based metabolic abnormalities affecting the kidney, and structural diseases affecting both the liver and the kidney, such as congenital hepatic fibrosis and polycystic kidney disease. When compared with sequential liver and kidney transplant, the rejection rate of both liver and kidney allografts was reported to be lower than with combined liver and kidney transplant. With proper anesthesia management, the probable increased complications with combined liver and kidney transplant can be prevented. In this report, we present the anesthesia care of a 22-year-old patient with primary hyperoxaluria type 1 who had deceased-donor combined liver and kidney transplant.