1
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Bouderlique E, Tang E, Perez J, Ea HK, Renaudin F, Coudert A, Vandermeersch S, Bazin D, Haymann JP, Saint-Jacques C, Frochot V, Daudon M, Letavernier E. Inflammation plays a critical role in 2,8-dihydroxyadenine nephropathy. CR CHIM 2022. [DOI: 10.5802/crchim.92] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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2
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Sharma M, Gowrishankar S, Jeloka TK. A Rare Case of APRT Deficiency with End-stage Renal Failure and Successful Renal Transplant. Indian J Nephrol 2021; 31:57-60. [PMID: 33994690 PMCID: PMC8101663 DOI: 10.4103/ijn.ijn_202_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/05/2019] [Accepted: 10/30/2019] [Indexed: 11/30/2022] Open
Abstract
Renal calculus disease is a common cause of renal injury. However, crystal nephropathy (uric acid, oxalate, and dihydroxyadenine) can present as chronic kidney disease without any evidence of renal stones. If left undiagnosed, there is a potential chance of recurrence in the allograft leading to graft failure after transplantation. Pretransplant identification and management can avoid such complications. Here, we describe a case of APRT deficiency leading to crystal nephropathy and end-stage renal failure in a patient who underwent a successful kidney transplant.
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Affiliation(s)
- Manish Sharma
- Department of Nephrology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
| | | | - Tarun K Jeloka
- Department of Nephrology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
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3
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Xiang J, Chen Z, Xu F, Mei S, Li Z, Zhou J, Dong Y, Gu Y, Huang Z, Hu Z. Outcomes of liver-kidney transplantation in patients with primary hyperoxaluria: an analysis of the scientific registry of transplant recipients database. BMC Gastroenterol 2020; 20:208. [PMID: 32620094 PMCID: PMC7333252 DOI: 10.1186/s12876-020-01349-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 06/17/2020] [Indexed: 12/23/2022] Open
Abstract
Background Primary hyperoxaluria (PH) is an inherited disease lacking of hepatic oxalic acid metabolic enzymes which could lead to irreverisible renal damage. Currently, liver–kidney transplantation is a curative but highly invasive therapy used to treat patients with PH. However, limited studies have focused on combined liver–kidney transplantation (CLKT) and sequential liver and kidney transplantation (SLKT) in patients with PH. Methods The present study included 201 patients with PH who received both liver and kidney transplants and who were listed on the Scientific Registry of Transplant Recipients from 1987 to 2018. According to the liver–kidney transplant procedure, patients were separated into a CLKT group and a SLKT group. Patient demographics and transplant outcomes were assessed in each group. Results Compared with the SLKT group, The CLKT group got a worse pretransplant dialysis condition in both the proportion of patients under pretransplant dialysis (p = 0.048) and the duration of the pretransplant dialysis (p < 0.001). The SLKT group got higher human leukocyte antigen mismatch score of kidney donor (p < 0.001) and liver donor (p = 0.003). The CLKT group utilized higher proportion (98.9%) of organs from a single deceased donor, while the SLKT group utilized 75.0% of organs from deceased liver donors and only 35.0% of organs from deceased kidney donors (p < 0.001). Kidney function measured by serum creatinine concentration before liver transplantation (LT) or CLKT was similar (p = 0.305) between groups. Patient survival was not significantly different between the two groups (p = 0.717) and liver (p = 0.685) and kidney (p = 0.464) graft outcomes were comparable between the two groups. Conclusions SLKT seems to be an alternative option with strict condition for CLKT, further exploration about the SLKT is still required.
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Affiliation(s)
- Jie Xiang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China
| | - Zheng Chen
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China
| | - Fangshen Xu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China.,Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, Zhejiang, China
| | - Shengmin Mei
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China
| | - Zhiwei Li
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China
| | - Jie Zhou
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China
| | - Yinlei Dong
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China
| | - Yangjun Gu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China
| | - Zhichao Huang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China
| | - Zhenhua Hu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China. .,Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, Zhejiang, China. .,Division of Hepatobiliary and Pancreatic Surgery, Yiwu Central Hospital, Yiwu, Zhejiang, China.
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4
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Eldo N, Srinivasan SP, Rajmohan N, Jacob M. Combined liver-kidney transplant in a 21-month-old child with type 1 primary hyperoxaluria-The perioperative challenges. Indian J Anaesth 2020; 64:432-435. [PMID: 32724255 PMCID: PMC7286408 DOI: 10.4103/ija.ija_871_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/06/2020] [Accepted: 02/17/2020] [Indexed: 11/10/2022] Open
Abstract
Primary hyperoxaluria type 1(PH 1) is the most common indication for a paediatric combined liver-kidney transplant. It is a technically challenging procedure. We describe the challenges in managing a 21-month-old female child weighing 7 kg for a combined liver-kidney transplant from two related living donors.
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Affiliation(s)
- Nidhin Eldo
- Department of Anesthesia and Critical Care, Astermed city, Kuttisahib Road Cheranalloor South Chitoor, Kochi, Kerala, India
| | - Sangeeth P Srinivasan
- Consultant Anaesthesiologist, Astermed city, Kuttisahib Road Cheranalloor South Chitoor, Kochi, Kerala, India
| | - Nisha Rajmohan
- Consultant Anaesthesiologist, Astermed city, Kuttisahib Road Cheranalloor South Chitoor, Kochi, Kerala, India
| | - Mathew Jacob
- Lead Consultant Integrated Liver Care, Astermed city, Kuttisahib Road Cheranalloor South Chitoor, Kochi, Kerala, India
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5
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Zaworski J, Bouderlique E, Anglicheau D, Duong Van Huyen JP, Gnemmi V, Gibier JB, Neugebauer Y, Haymann JP, Bazin D, Frochot V, Daudon M, Letavernier E. 1-Methyluric Acid Nephropathy. Kidney Int Rep 2020; 5:737-741. [PMID: 32405596 PMCID: PMC7210604 DOI: 10.1016/j.ekir.2020.02.1026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Jeremy Zaworski
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche-S 1155, Assistance Publique des Hôpitaux de Paris Service des Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, Paris, France
| | - Elise Bouderlique
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche-S 1155, Assistance Publique des Hôpitaux de Paris Service des Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, Paris, France
| | - Dany Anglicheau
- Department of Nephrology and Kidney Transplantation, Paris Descartes, Sorbonne Paris Cité University, Institut National de la Santé et de la Recherche Médicale U1151, Necker Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jean-Paul Duong Van Huyen
- Department of Pathology, Paris Descartes, Sorbonne Paris Cité University, Necker Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Viviane Gnemmi
- Department of Pathology, University Lille, Centre National de la Recherche Scientifique, Inserm, Centre Hospitalier Universitaire Lille, Unité Mixte de recherche 9020 - Unité Mixte de recherche-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, Lille, France.,Centre de Biologie et Pathologie, Centre Hospitalier Universitaire Lille, Lille, France
| | - Jean-Baptiste Gibier
- Department of Pathology, University Lille, Centre National de la Recherche Scientifique, Inserm, Centre Hospitalier Universitaire Lille, Unité Mixte de recherche 9020 - Unité Mixte de recherche-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, Lille, France.,Centre de Biologie et Pathologie, Centre Hospitalier Universitaire Lille, Lille, France
| | - Yann Neugebauer
- Service de néphrologie et dialyse, centre hospitalier de Douai, Douai, France
| | - Jean-Philippe Haymann
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche-S 1155, Assistance Publique des Hôpitaux de Paris Service des Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, Paris, France
| | - Dominique Bazin
- Laboratoire de Chimie Physique, Centre National de la Recherche Scientifique, Université Paris Sud, Orsay, France
| | - Vincent Frochot
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche-S 1155, Assistance Publique des Hôpitaux de Paris Service des Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, Paris, France
| | - Michel Daudon
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche-S 1155, Assistance Publique des Hôpitaux de Paris Service des Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, Paris, France
| | - Emmanuel Letavernier
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche-S 1155, Assistance Publique des Hôpitaux de Paris Service des Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, Paris, France
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6
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Klinkhammer BM, Djudjaj S, Kunter U, Palsson R, Edvardsson VO, Wiech T, Thorsteinsdottir M, Hardarson S, Foresto-Neto O, Mulay SR, Moeller MJ, Jahnen-Dechent W, Floege J, Anders HJ, Boor P. Cellular and Molecular Mechanisms of Kidney Injury in 2,8-Dihydroxyadenine Nephropathy. J Am Soc Nephrol 2020; 31:799-816. [PMID: 32086278 DOI: 10.1681/asn.2019080827] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/05/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Hereditary deficiency of adenine phosphoribosyltransferase causes 2,8-dihydroxyadenine (2,8-DHA) nephropathy, a rare condition characterized by formation of 2,8-DHA crystals within renal tubules. Clinical relevance of rodent models of 2,8-DHA crystal nephropathy induced by excessive adenine intake is unknown. METHODS Using animal models and patient kidney biopsies, we assessed the pathogenic sequelae of 2,8-DHA crystal-induced kidney damage. We also used knockout mice to investigate the role of TNF receptors 1 and 2 (TNFR1 and TNFR2), CD44, or alpha2-HS glycoprotein (AHSG), all of which are involved in the pathogenesis of other types of crystal-induced nephropathies. RESULTS Adenine-enriched diet in mice induced 2,8-DHA nephropathy, leading to progressive kidney disease, characterized by crystal deposits, tubular injury, inflammation, and fibrosis. Kidney injury depended on crystal size. The smallest crystals were endocytosed by tubular epithelial cells. Crystals of variable size were excreted in urine. Large crystals obstructed whole tubules. Medium-sized crystals induced a particular reparative process that we term extratubulation. In this process, tubular cells, in coordination with macrophages, overgrew and translocated crystals into the interstitium, restoring the tubular luminal patency; this was followed by degradation of interstitial crystals by granulomatous inflammation. Patients with adenine phosphoribosyltransferase deficiency showed similar histopathological findings regarding crystal morphology, crystal clearance, and renal injury. In mice, deletion of Tnfr1 significantly reduced tubular CD44 and annexin two expression, as well as inflammation, thereby ameliorating the disease course. In contrast, genetic deletion of Tnfr2, Cd44, or Ahsg had no effect on the manifestations of 2,8-DHA nephropathy. CONCLUSIONS Rodent models of the cellular and molecular mechanisms of 2,8-DHA nephropathy and crystal clearance have clinical relevance and offer insight into potential future targets for therapeutic interventions.
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Affiliation(s)
| | | | | | | | | | - Thorsten Wiech
- Institute of Pathology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; and
| | | | - Sverrir Hardarson
- Department of Pathology Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Shrikant R Mulay
- Division of Nephrology, Klinikum der Universität, LMU München, Munich, Germany
| | | | | | | | - Hans-Joachim Anders
- Division of Nephrology, Klinikum der Universität, LMU München, Munich, Germany
| | - Peter Boor
- Institute of Pathology, .,Division of Nephrology and Immunology.,Department of Electron Microscopy, RWTH University Hospital Aachen, Aachen, Germany
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7
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Cai R, Lin M, Chen Z, Lai Y, Huang X, Zhao G, Guo X, Xiong Z, Chen J, Chen H, Jiang Q, Liu S, Yang Y, Liang W, Zou M, Liu T, Chen W, Liu H, Peng J. Primary hyperoxaluria diagnosed after kidney transplantation failure: lesson from 3 case reports and literature review. BMC Nephrol 2019; 20:224. [PMID: 31215412 PMCID: PMC6582561 DOI: 10.1186/s12882-019-1402-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 05/28/2019] [Indexed: 12/16/2022] Open
Abstract
Background Primary hyperoxaluria (PH) is a rare inborn disorder of the metabolism of glyoxylate, which causes the hallmark production oxalate and forms insoluble calcium oxalate crystals that accumulate in the kidney and other organs. Since the manifestation of PH varies from recurrent nephrolithiasis, nephrocalcinosis, and end-stage renal disease with age at onset of symptoms ranging from infancy to the sixth decade, the disease remains undiagnosed until after kidney transplantation in some cases. Case presentation Herein, we report 3 cases of PH diagnosed after kidney transplantation failure, providing the comprehensive clinical course, the ultrasonic image of renal graft and pathologic image of the biopsy, highlighting the relevance of biopsy findings and the results of molecular genetic testing. We also focus on the treatment and the unfavorable outcome of the patients. Meanwhile, we review the literature and show the additional 10 reported cases of PH diagnosed after kidney transplantation. Additionally, we discuss the progressive molecular understanding of the mechanisms involved in PH and molecular therapy. Conclusions Overall, the necessity of preoperative screening of PH in all patients even with a minor history of nephrolithiasis and the importance of proper treatment are the lessons we learn from the 3 cases, which prompt us to avoid tragedies. Electronic supplementary material The online version of this article (10.1186/s12882-019-1402-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ruiming Cai
- Department of Organ Transplantation, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Minzhuang Lin
- Department of Organ Transplantation, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Zhiyong Chen
- Department of Organ Transplantation, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Yongtong Lai
- Department of Organ Transplantation, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Xianen Huang
- Department of Organ Transplantation, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Guozhi Zhao
- Department of Organ Transplantation, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Xuekun Guo
- Department of Organ Transplantation, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Zhongtang Xiong
- Department of Pathology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, 510150, People's Republic of China
| | - Juan Chen
- Department of Pathology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, 510150, People's Republic of China
| | - Hui Chen
- Department of Pathology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, 510150, People's Republic of China
| | - Qingping Jiang
- Department of Pathology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, 510150, People's Republic of China
| | - Shaoyan Liu
- Department of Pathology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, 510150, People's Republic of China
| | - Yuexin Yang
- Department of Pathology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, 510150, People's Republic of China
| | - Weixiang Liang
- Department of Ultrasound, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Minhui Zou
- Department of Ultrasound, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Tao Liu
- Department of Ultrasound, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Wenfang Chen
- Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Hongzhou Liu
- Department of Clinical Laboratory, Guangzhou Kingmed Center for Clinical Laboratory Co., Ltd, Guangzhou, 510330, China
| | - Juan Peng
- Department of Pathology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, 510150, People's Republic of China.
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8
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Ozer A, Aktas H, Bulum B, Emiroglu R. The experience of combined and sequential liver and kidney transplantation from a single living donor in patients with primary hyperoxaluria type 1. Pediatr Transplant 2019; 23:e13406. [PMID: 30932299 DOI: 10.1111/petr.13406] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/07/2019] [Accepted: 02/12/2019] [Indexed: 12/13/2022]
Abstract
LKT is the only effective treatment for PH1 because it replaces both the source (liver) and the target (kidney) of the disease. Most studies report on LKT in patients with PH1 from deceased donors. This study reports on five patients who underwent LKT from a single living donor between April 2017 and March 2018. Combined LKT was performed for 1 patient and sequential LKT for the remainder. The median age of the patients at the time of diagnosis and transplantation was 5.5 (0.3-18) and 10 (6-21) years, respectively. All patients received left lateral liver segment transplantation, except one patient who received right liver lobe transplantation. No liver graft loss was observed, and liver function tests were stable at the final evaluation of all patients. Renal function tests of the patients were also stable at the final assessment, except for the young adult patient. None of the patients suffered from acute rejection. One patient died at the second month following liver transplantation due to severe pneumonia and sepsis. This study concludes that combined or sequential LKT from a single living donor can be safely performed and provides encouraging results for even the youngest and smallest patients with PH1.
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Affiliation(s)
- Ali Ozer
- Department of Organ Transplantation, Acibadem Mehmet Ali Aydinlar University Atakent Hospital, Istanbul, Turkey
| | - Hikmet Aktas
- Department of Organ Transplantation, Acibadem Mehmet Ali Aydinlar University Atakent Hospital, Istanbul, Turkey
| | - Burcu Bulum
- Department of Pediatric Nephrology, Acibadem Mehmet Ali Aydinlar University Atakent Hospital, Istanbul, Turkey
| | - Remzi Emiroglu
- Department of Organ Transplantation, Acibadem Mehmet Ali Aydinlar University Atakent Hospital, Istanbul, Turkey
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9
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Meeting report of the "Symposium on kidney stones and mineral metabolism: calcium kidney stones in 2017". J Nephrol 2019; 32:681-698. [PMID: 30680550 DOI: 10.1007/s40620-019-00587-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/16/2019] [Indexed: 02/06/2023]
Abstract
A symposium on kidney stones and mineral metabolism held on December 2017 in Brussels, Belgium was the first international multidisciplinary conference of the International Collaborative Network on Kidney Stones and Mineral Metabolism. This meeting addressed epidemiology, underlying pathophysiological mechanisms, genetics, pathological, as well as clinical and research topics. The participants included clinicians and recognized experts in the field from Europe and the United States interacted closely during the symposium which promoted a chance to explore new frontiers in the field of kidney stone disease. This manuscript summarizes some of the major highlights of the meeting.
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10
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Hill F, Sayer JA. Precision medicine in renal stone-formers. Urolithiasis 2018; 47:99-105. [PMID: 30460526 PMCID: PMC6373186 DOI: 10.1007/s00240-018-1091-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/08/2018] [Indexed: 12/22/2022]
Abstract
Here we define precision medicine approaches and discuss how these may be applied to renal stone-formers to optimise diagnosis and a management. Using the gene discovery of monogenic stone disorders as examples, we discuss the benefits of personalising therapies for renal stone-formers to provide improved prevention and treatment of these disorders.
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Affiliation(s)
- Fay Hill
- Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle, NE1 3BZ, UK
| | - John A Sayer
- Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle, NE1 3BZ, UK. .,Renal Services, Newcastle upon Tyne NHS Foundation Trust, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK. .,NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne, NE4 5PL, UK.
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11
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Huq A, Nand K, Juneja R, Winship I. APRT deficiency: the need for early diagnosis. BMJ Case Rep 2018; 2018:bcr-2018-225742. [DOI: 10.1136/bcr-2018-225742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Adenine phosphoribosyltransferase (APRT) deficiency is a rare autosomal recessive disorder which leads to accumulation of poorly soluble 2,8-dihydroxyadenine in kidneys resulting in nephrolithiasis as well as chronic kidney disease from crystal nephropathy. This report describes a 55-year-old previously fit man who presented with shortness of breath and the investigative pathway that eventually led to a diagnosis of APRT deficiency. Early diagnosis has aided in timely institution of allopurinol, thereby improving his renal function and possibility of weaning off renal replacement therapy. Genetic testing has enabled early identification of other family members at risk and prevention of renal failure by commencing xanthine oxidoreductase (XOR) inhibitors. The issues surrounding kidney donation by a member of this family are also discussed. This case represents the importance of awareness and recognition of the signs and symptoms of this rare condition, complications of which can be easily prevented by early institution of XOR inhibitor therapy.
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12
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Abstract
RATIONALE Urinary lithiasis is one of severe postoperative complications in patients undergoing renal transplantation, possibly leading to anuria, urinary infection, or even acute renal failure. Potassium sodium hydrogen citrate (PSHC), a potassium-bearing citrate, is commonly prescribed to prevent stone formation. PATIENT CONCERNS A 25-year-old man (patient 1) and a 31-year-old man (patient 2) receiving renal transplantation for end-stage renal disease (ESRD) were enrolled in this study. They were given 10 g/day of PSHC granules from the ninth day to the 17th day after surgery. Patient 1 presented chest tightness, nausea, muscle weakness, and ascending paralysis on the 10th day. Patient 2 presented weak waves on EGG on the 17th day. Moreover, their serum potassium concentrations (SPCs) were 7.67 and 6.05 mmol/L, respectively. DIAGNOSIS Acute hyperkalemia. INTERVENTIONS Hemo-filtration was performed for patient 1, while patient 2 received 10% calcium gluconate 10 mL, 5% NaHCO3 125 mL, and 10% glucose 500 mL with the addition of 10 units of insulin through intravenous drip. OUTCOMES Their SPCs dropped to the normal range. LESSONS Physicians should pay close attentions to potential risks caused by PSHC, and monitor the SPCs to minimize the occurrence of hyperkalemia.
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13
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Nanmoku K, Kurosawa A, Shinzato T, Shimizu T, Kimura T, Yagisawa T. Febuxostat for the Prevention of Recurrent 2,8-dihydroxyadenine Nephropathy due to Adenine Phosphoribosyltransferase Deficiency Following Kidney Transplantation. Intern Med 2017; 56:1387-1391. [PMID: 28566603 PMCID: PMC5498204 DOI: 10.2169/internalmedicine.56.8142] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Adenine phosphoribosyltransferase (APRT) deficiency is a rare autosomal recessive disorder that results in irreversible renal damage due to 2,8-dihydroxyadenine (DHA) nephropathy. A 28-year-old man underwent living-related kidney transplantation for chronic kidney disease of unknown etiology. Numerous spherical brownish crystals observed in his urinary sediment on postoperative day 3 and were observed within the tubular lumen of renal allograft biopsy specimens on postoperative day 7. After a genetic diagnosis, febuxostat treatment was started on postoperative day 7, with the dosage gradually increased to 80 mg/day until complete the disappearance of 2,8-DHA crystals. Febuxostat prevented secondary 2,8-DHA nephropathy after kidney transplantation.
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Affiliation(s)
- Koji Nanmoku
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Japan
| | - Akira Kurosawa
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Japan
| | - Takahiro Shinzato
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Japan
| | - Toshihiro Shimizu
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Japan
| | - Takaaki Kimura
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Japan
| | - Takashi Yagisawa
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Japan
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