Oxalate retinopathy is irreversible despite early combined liver-kidney transplantation in primary hyperoxaluria type 1.
Adolescent
Child
Child, Preschool
Female
Follow-Up Studies
Graft Rejection
/ etiology
Graft Survival
Humans
Hyperoxaluria, Primary
/ surgery
Infant
Liver Transplantation
/ adverse effects
Male
Oxalates
/ metabolism
Postoperative Complications
/ etiology
Prognosis
Retinal Diseases
/ etiology
Retrospective Studies
Risk Factors
clinical research/practice
congenital
dialysis
genetics
hepatorenal syndrome
kidney disease
kidney transplantation/nephrology
liver disease
liver transplantation/hepatology
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
23
02
2019
revised:
30
04
2019
accepted:
08
05
2019
pubmed:
4
6
2019
medline:
18
9
2020
entrez:
2
6
2019
Statut:
ppublish
Résumé
In primary hyperoxaluria type 1 (PH1), systemic oxalate deposition (oxalosis) in end-stage renal disease (ESRD) is associated with high morbidity and mortality, particularly in children with infantile oxalosis (IO). Combined liver and kidney transplantation (CLKT) is the only curative treatment option in these patients. After CLKT, systemic oxalosis decreases continuously, although only insufficient data are available regarding oxalate retinopathy (ROx), leading to severe visual impairment. We analyzed long-term follow-up data of ROx in 13 patients undergoing CLKT for PH1 at our center between 1998 and 2018. Age at transplantation was 1.3-14.2 years, including nine patients with IO. We performed visual acuity testing, slit lamp investigation, funduscopy, fundus photography, and spectral-domain optical coherence tomography (SD-OCT) imaging. Severe (grade 2-4) ROx was present in all nine children with IO but not in the four patients developing ESRD in adolescence. A significant negative correlation was found between age at onset of ESRD and grade of ROx (r = -0.66; P < .001). Notably, follow-up assessment after CLKT demonstrated no regression of ROx after a median of 5.3 years (range 0.6-14). The data show that despite early CLKT in IO, ROx is irreversible and the concomitant visual deterioration occurs prior to transplantation.
Identifiants
pubmed: 31152479
doi: 10.1111/ajt.15484
pii: S1600-6135(22)09332-7
doi:
Substances chimiques
Oxalates
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
3328-3334Informations de copyright
© 2019 The American Society of Transplantation and the American Society of Transplant Surgeons.
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