Publication details

Transplantation outcomes in primary hyperoxaluria

Authors	BERGSTRALH EJ ADEY D MONICO CG AHMED S LIESKE JC AIGBE M HERGES RM ALEXANDER S LANGMAN CB ANDERS M HOPPE B AMIN N MILLINER DS ASHETTE M ASPLIN JR AZAM N BALAKRISHNAN N BHANDARE S BAUM M BECKER B BECKMAN D BEIKEN S BELANI S BELLUCCI A BERKSETH R BERRY P BHAKTA N BHAT A BHUPALAM S BIA M BLYDT-HANSEN T BOUSQUET R BRAUN M BREWER E BRUEGGMEYER C BUNCHMAN T BUTANI L CADNAPAPHORNCHAI M CASTILLO-VELARDE LIMA E CHOI MJ CHYBOWSKI M CUITARESE F COPELOVITCH L CORBIN F COREY H CREEMERS D CUNNIGHAM R DALINGHAUS K DAVIS I DE SOUZA C DEBEUKALEAR M DELANEY V DEVARAJAN P DOLEŽEL Zdeněk DOLL HA DOUVILLE P ECKLUND S
Year of publication	2010
Type	Article in Periodical
Magazine / Source	American Journal of Transplantattion
MU Faculty or unit	Faculty of Medicine
Citation
Field	Paediatry
Keywords	primary hyperoxaluria transplantation diagnose
Description	Optimal transplantation strategies are uncertain in primary hyperoxaluria (PH) due to potential for recurrent oxalosis. Outcomes of different transplantation approaches were compared using life-table methods to determine kidney graft survival among 203 patients in the International Primary Hyperoxaluria Registry. From 1976-2009, 84 kidney alone (K) and combined kidney and liver (K + L) transplants were performed in 58 patients. Among 58 first kidney transplants (32 K, 26 K + L), 1-, 3- and 5-year kidney graft survival was 82%, 68% and 49%. Renal graft loss occurred in 26 first transplants due to oxalosis in ten, chronic allograft nephropathy in six, rejection in five and other causes in five. Delay in PH diagnosis until after transplant favored early graft loss (p = 0.07). K + L had better kidney graft outcomes than K with death-censored graft survival 95% versus 56% at 3 years (p = 0.011). Among 29 year 2000-09 first transplants (24 K + L), 84% were functioning at 3 years compared to 55% of earlier transplants (p = 0.05). At 6.8 years after transplantation, 46 of 58 patients are living (43 with functioning grafts). Outcomes of transplantation in PH have improved over time, with recent K + L transplantation highly successful. Recurrent oxalosis accounted for a minority of kidney graft losses. Optimal transplantation strategies are uncertain in primary hyperoxaluria (PH) due to potential for recurrent oxalosis. Outcomes of different transplantation approaches were compared using life-table methods to determine kidney graft survival among 203 patients in the International Primary Hyperoxaluria Registry. From 1976-2009, 84 kidney alone (K) and combined kidney and liver (K + L) transplants were performed in 58 patients. Among 58 first kidney transplants (32 K, 26 K + L), 1-, 3- and 5-year kidney graft survival was 82%, 68% and 49%. Renal graft loss occurred in 26 first transplants due to oxalosis in ten, chronic allograft nephropathy in six, rejection in five and other causes in five. Delay in PH diagnosis until after transplant favored early graft loss (p = 0.07). K + L had better kidney graft outcomes than K with death-censored graft survival 95% versus 56% at 3 years (p = 0.011). Among 29 year 2000-09 first transplants (24 K + L), 84% were functioning at 3 years compared to 55% of earlier transplants (p = 0.05). At 6.8 years after transplantation, 46 of 58 patients are living (43 with functioning grafts). Outcomes of transplantation in PH have improved over time, with recent K + L transplantation highly successful. Recurrent oxalosis accounted for a minority of kidney graft losses. Impact Factor 6.433