Combined liver-kidney transplant in a 21-month-old child with type 1 primary hyperoxaluria-The perioperative...

Area of Science:

• Pediatric surgery
• Organ transplantation
• Nephrology

Background:

• Primary hyperoxaluria type 1 (PH 1) is a rare genetic disorder leading to severe kidney damage.
• PH 1 is the primary indication for pediatric combined liver-kidney transplantation.
• Combined liver-kidney transplantation is a complex procedure, especially in young children.

Observation:

• A 21-month-old female child weighing 7 kg presented with PH 1.
• The patient required a combined liver-kidney transplant.
• Two related living donors were utilized for the transplantation.

Findings:

• The management of pediatric combined liver-kidney transplantation for PH 1 presents unique technical challenges.
• Utilizing related living donors adds specific considerations to the surgical and postoperative care.
• Successful transplantation in a small pediatric patient requires meticulous planning and execution.

Implications:

• This case underscores the critical need for specialized centers experienced in pediatric liver and kidney transplantation.
• Advances in surgical techniques and donor management are crucial for improving outcomes in PH 1 patients.
• Further research into optimizing perioperative care for very young children undergoing combined organ transplantation is warranted.