Long-Term Results of Combined Liver-Kidney Transplantation for Primary Hyperoxaluria Type 1: The French Experience

Philippe Compagnon; Philippe Metzler; Didier Samuel; Christophe Camus; Patrick Niaudet; Antoine Durrbach; Philippe Lang; Daniel Azoulay; Christophe Duvoux; Francois Bayle; Joseph Rivalan; Pierre Merville; Gérard Pascal; Eric Thervet; Albert Bensman; Lionel Rostaing; Georges Deschênes; Jeff Morcet; Cyrille Féray; Karim Boudjema

doi:10.1002/lt.24009

journal article Dec 01, 2014

Long-Term Results of Combined Liver-Kidney Transplantation for Primary Hyperoxaluria Type 1: The French Experience

Philippe Compagnon Philippe Metzler Didier Samuel

Christophe Camus Patrick Niaudet Antoine Durrbach

Philippe Lang

Daniel Azoulay Christophe Duvoux

Francois Bayle Joseph Rivalan Pierre Merville Gérard Pascal Eric Thervet Albert Bensman Lionel Rostaing

Georges Deschênes Jeff Morcet Cyrille Féray Karim Boudjema

Liver Transplantation Vol. 20 No. 12 pp. 1475-1485 · Ovid Technologies (Wolters Kluwer Health)

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Abstract

Primary hyperoxaluria type 1 (PH1) is a hepatic metabolic defect leading to end-stage renal failure. The posttransplant recurrence of kidney disease can suggest a need for combined liver-kidney transplantation (LKT). However, the risk of LKT is theoretically far higher than the risk of kidney-alone transplantation (KAT). An unselected consecutive series of 54 patients with PH1 was analyzed according to the type of transplantation initially performed between May 1979 and June 2010 at 10 French centers. The duration of dialysis, extrarenal lesions, age, and follow-up were similar between the groups. Postoperative morbidity and mortality did not differ between the groups, and 10-year patient survival rates were similar for the LKT (n = 33) and KAT groups (n = 21; 78% versus 70%). Kidney graft survival at 10 years was better after LKT (87% versus 13%, P < .001). Four patients (12.1%) lost their first kidney graft in the LKT group, whereas 19 (90%) did in the KAT group (P < .001). The recurrence of oxalosis occurred in 11 renal grafts (52%) in the KAT group but in none in the LKT group (P < .001). End-stage renal failure resulting from rejection was also higher in the KAT group (19% versus 9%, P < 0.0001). A second kidney transplant was performed for 15 patients (71%) in the KAT group versus 4 patients (12%) in the LKT group (P < 0.001). In conclusion, LKT for PH1 provides better kidney graft survival, less rejection, and similar long-term patient survival and is not associated with an increased short-term mortality risk. LKT must be the first-line treatment for PH1 patients with end-stage renal disease. Liver Transpl 20:1475–1485, 2014. © 2014 AASLD.

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References

Details

Published: Dec 01, 2014
Vol/Issue: 20(12)
Pages: 1475-1485
License: View

Authors

Centre Hospitalier Universitaire Rennes, Maladies Infectieuses et Réanimation Médicale, Rennes, France; Institut National de la Santé et de la Recherche Médicale, Centre d’Investigation Clinique-1414, and

Université Paris 7-Denis Diderot, ITODYS, UMR CNRS 7086, case 7090, 2 place Jussieu, F-75251 Paris Cedex 05, France, Central Michigan University, Department of Physics, Mt. Pleasant, Michigan 48859, and Université de Toulouse, INSA, LPCNO, UMR CNRS 5215, 135 av. de Rangueil, 31077 Toulouse Cedex 4, France

Department of Nephrology and Organ Transplantation; University Hospital; Toulouse France; INSERM U563; IFR-BMT; CHU Purpan; Toulouse France; University Paul Sabatier; Toulouse France

G

Georges Deschênes

Departments of Pediatric Nephrology (T.U., L.P., A.B., G.D.), 75571 Paris Cedex 12, France

Villejuif France

Cite This Article

Philippe Compagnon, Philippe Metzler, Didier Samuel, et al. (2014). Long-Term Results of Combined Liver-Kidney Transplantation for Primary Hyperoxaluria Type 1: The French Experience. Liver Transplantation, 20(12), 1475-1485. https://doi.org/10.1002/lt.24009

Long-Term Results of Combined Liver-Kidney Transplantation for Primary Hyperoxaluria Type 1: The French Experience

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