Sequential kidney-liver transplantation from the same living donor for lecithin cholesterol acyl transferase deficiency

Clin Transplant. 2016 Oct;30(10):1370-1374. doi: 10.1111/ctr.12826. Epub 2016 Sep 24.

Abstract

Background: Lecithin cholesterol acyl transferase (LCAT) deficiency is a rare autosomal recessive disorder of lipoprotein metabolism that results in end-stage renal disease (ESRD) necessitating transplantation. As LCAT is produced in the liver, combined kidney and liver transplantation was proposed to cure the clinical syndrome of LCAT deficiency.

Methods: A 29-year-old male with ESRD secondary to LCAT deficiency underwent a sequential kidney-liver transplantation from the same living donor (LD). One year following the kidney transplant, auxiliary partial orthotopic liver transplant (APOLT) of a left lateral segment from the same donor was performed.

Results: At 5 years follow-up, there have been no major complications, readmissions, or rejection episodes. Serum lipid abnormalities recurred within the first year, but liver and kidney allograft function remains intact.

Conclusion: Few cases of sequential transplantation from the same LD have been performed in adults. This is the first APOLT and multi-organ transplant performed for LCAT deficiency. Sequential organ transplant from the same LD for ESRD secondary to a metabolic disorder of the liver is feasible in adults and should be further investigated.

Keywords: auxiliary liver transplantation; kidney transplantation; liver transplantation; living donor transplantation; sequential organ transplant.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Humans
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / methods*
  • Lecithin Cholesterol Acyltransferase Deficiency / complications
  • Lecithin Cholesterol Acyltransferase Deficiency / surgery*
  • Liver Transplantation / methods*
  • Living Donors*
  • Male