Intra-operative continuous renal replacement therapy during combined liver-kidney transplantation in two patients with primary hyperoxaluria type 1

Casper F M Franssen; Ido P Kema; Douglas J Eleveld; Robert J Porte; Jaap J Homan van der Heide

doi:10.1093/ndtplus/sfq216

Intra-operative continuous renal replacement therapy during combined liver-kidney transplantation in two patients with primary hyperoxaluria type 1

NDT Plus. 2011 Apr;4(2):113-6. doi: 10.1093/ndtplus/sfq216. Epub 2011 Feb 10.

Authors

Casper F M Franssen¹, Ido P Kema², Douglas J Eleveld³, Robert J Porte⁴, Jaap J Homan van der Heide¹

Affiliations

¹ Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
² Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
³ Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁴ Department of Surgery, Hepatobiliary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Abstract

Liver-kidney transplantation in patients with primary hyperoxaluria type 1 (PH1) and a high systemic oxalate load is often complicated by oxalate deposition in the renal allograft and loss of renal function. Intensive pre- and post-operative haemodialysis (HD) cannot completely prevent rises in plasma oxalate levels during transplantation because of rebound from saturated oxalate stores. Continuous renal replacement therapy may overcome this problem. In two PH1 patients with extensive oxalate accumulation, we found that intra-operative continuous venovenous haemodiafiltration effectively cleared oxalate and kept oxalate at relatively low levels following preoperative HD.

Keywords: CVVH; dialysis; primary hyperoxaluria; transplantation.

Publication types

Case Reports