oxalates and Cadaver

In PH, PLTX, although ideal in theory, is rarely achieved. Patients usually have reached end-stage kidney disease while requiring combined liver and kidney transplantation. In this combined procedure, the sudden high oxalates mobilization from blood and tissue stores jeopardizes the success of the kidney graft, with a high risk of post-transplant early kidney necrosis or chronic graft damage. Here, we report the case of a three-yr-old girl with PH and ESRF in whom we performed sequentially deceased donor liver transplantation followed four months later by living donor kidney transplant, after normalization of blood oxalate levels and improvement of urinary oxalate output. After this two-step transplantation, our patient showed normalization of renal function with good urinary output and maintained normal blood oxalate levels. This strategy seems to be a reasonable approach in order to avoid acute renal tubular injury because of oxalate excretion in these patients.

Topics: Cadaver; Child, Preschool; Female; Graft Survival; Humans; Hyperoxaluria, Primary; Kidney Diseases; Kidney Transplantation; Liver Diseases; Liver Transplantation; Oxalates; Risk; Treatment Outcome

The prevalence of gallstones is low in Asians. In Iran, many factors influence the prevalence of this disease. The aim of this study was to determine the prevalence of gallbladder stones and their chemical characteristics in a population by the study of cadavers.. In this cross-sectional study, autopsies were performed on 253 cadavers of more than 13 years old. The cadavers were studied to determine the number, location of stone formation, chemical composition, dry weight, and mean diameter of stones in the gallbladder and common bile duct.. The prevalence of gallstone disease in these cadavers was 6.3% (men 4.7%, women 8.6%, not significantly different, P=0.216). There was a positive relationship between the age and prevalence of gallstone disease (P=0.033). The most common stone compositions were cholesterol and oxalate. The mean diameter (P=0.0058) and dry weight (P<0.0001) of stones were higher in the gallbladder than in the common bile duct. Positive relations between the amount of oxalate and mean diameter, and between the amount of oxalate and mean dry weight of gallstones were found, but the relationship between the amount of cholesterol and mean diameter was inverse.. The prevalence of gallstones differed among age groups. Diameter and dry weight of gallstones were dependent on location of stone formation and chemical composition.

Topics: Adolescent; Adult; Aged; Cadaver; Cholesterol; Cross-Sectional Studies; Female; Gallstones; Humans; Iran; Male; Middle Aged; Oxalates; Prevalence

Liver transplantation (LTX) corrects the enzymatic defect responsible for type 1 primary hyperoxaluria (PH1). It has been advocated in combination with kidney transplantation (KTX) in patients with renal failure from PH1 because KTX alone can result in early graft loss. A 58-year-old male patient with PH1 on hemodialysis underwent resection of the left lateral segment of the liver followed by orthotopic auxiliary left lateral segment liver transplantation and kidney transplantation from a deceased donor. The serum oxalate dropped from 34.8 micromol/L before transplant to 3.6-8.3 in the first months posttransplant to <1 micromol/L (normal range 0.4-3.0). One year after posttransplant, the patient has an iothalamate glomerular filtration rate of 58 ml/min. Orthotopic auxiliary LTX is an alternative to whole LTX in PH1. By using a split deceased donor liver, it does not deprive the donor pool and protects the recipient from liver failure in case of graft loss.

Topics: Cadaver; DNA Mutational Analysis; Glomerular Filtration Rate; Graft Rejection; Graft Survival; Humans; Hyperoxaluria, Primary; Kidney Transplantation; Liver; Liver Transplantation; Magnetic Resonance Imaging; Male; Middle Aged; Oxalates; Renal Dialysis; Time Factors; Tissue Donors; Transaminases

Many aspects of calcium oxalate (CaOx) deposition in renal transplant biopsies are not known. Review of all renal transplant biopsies performed in a 7-year period showed that CaOx deposition could be classified into three groups. Group I: Seven biopsies within a month post-transplant displayed rare CaOx foci against a background of acute tubular necrosis or acute cell-mediated rejection. At follow-up, five grafts functioned well and two failed due to chronic allograft nephropathy. CaOx in this context was an incidental finding secondary to a sudden excretion of an end-stage renal disease-induced increased body burden of CaOx. Group II: Two biopsies performed 2 and 10 months post-transplant showed rare CaOx foci against a background of chronic allograft nephropathy, leading to graft loss. CaOx in this context reflected nonspecific parenchymal deposition due to chronic renal failure regardless of causes. Group III: One biopsy with recurrent PH1 characterized by marked CaOx deposition associated with severe tubulointerstitial injury and graft loss 6 months post-transplant. There were two previously reported cases in which CaOx deposition in the renal allografts was due the antihypertensive drug naftidrofuryl oxalate or increased intestinal absorption of CaOx. CaOx deposition in renal allografts can be classified in different categories with distinctive morphologic features and clinical implications.

Topics: Absorption; Adolescent; Adult; Aged; Biopsy; Cadaver; Calcium Oxalate; Creatinine; Female; Graft Rejection; Humans; Kidney Transplantation; Kidney Tubules; Living Donors; Male; Middle Aged; Nafronyl; Necrosis; Oxalates; Renal Insufficiency; Time Factors; Transplantation, Homologous; Vasodilator Agents

Topics: Adult; Amyloidosis; Cadaver; Child; Cystinosis; Diabetic Nephropathies; Fabry Disease; Female; HLA Antigens; Humans; Kidney Diseases; Kidney Transplantation; Male; Metabolic Diseases; Middle Aged; Oxalates; Registries; Transplantation, Homologous

Topics: Acute Kidney Injury; Adult; Biopsy; Cadaver; Child; Graft Rejection; Humans; Kidney; Kidney Function Tests; Kidney Transplantation; Male; Metabolism, Inborn Errors; Middle Aged; Nephrectomy; Oxalates; Postoperative Complications; Pyridoxine; Time Factors; Transplantation, Homologous

Topics: Biopsy; Cadaver; Child, Preschool; Female; Graft Rejection; Humans; Immunosuppressive Agents; Kidney; Kidney Transplantation; Metabolism, Inborn Errors; Nephrocalcinosis; Oxalates; Peritoneal Dialysis; Transplantation, Homologous

Topics: Adult; Autopsy; Biopsy; Cadaver; Creatinine; Female; Humans; Kidney Calculi; Kidney Failure, Chronic; Kidney Transplantation; Metabolism, Inborn Errors; Oxalates; Renal Dialysis; Transplantation, Homologous

Topics: Acute Kidney Injury; Adult; Cadaver; Female; Fundus Oculi; Humans; Hydrochlorothiazide; Kidney Calculi; Kidney Cortex; Kidney Transplantation; Metabolism, Inborn Errors; Methylene Blue; Oxalates; Pyelonephritis; Pyridoxine; Transplantation, Homologous; Urinary Tract Infections

Topics: Adult; Autopsy; Cadaver; Creatinine; Graft Rejection; Humans; Immunosuppression Therapy; Kidney; Kidney Calculi; Kidney Transplantation; Male; Metabolism, Inborn Errors; Nephrectomy; Oxalates; Transplantation, Homologous