Kidney transplantation in primary oxalosis

A 33 year old patient with primary oxalosis was submitted to cadaver kidney transplantation after 15 months treatment by hemodialysis. During the dialysis period, he developed complete heart block which immediately followed bilateral nephrectomy. The transplant functioned correctly and was found to excrete large amounts of oxalate. Death, which supervened 7 months after transplantation, was due to miliary tuberculosis. The patient's own kidneys and various organs examined post mortem showed extensive oxalate deposits, which were mainly observed in the graft, conducting system of the heart, ocular structures, spleen and pancreas. The problems of managing terminal uremia secondary to primary oxalosis are discussed.