COMBINED LIVER-KIDNEY TRANSPLANTATION IN PRIMARY HYPEROXALURIA .1. BONE HISTOPATHOLOGY AND OXALATE BODY CONTENT

In three patients with end-stage renal failure due to primary hyperoxa luria type 1, successful combined liver-kidney transplantation enabled us to assess the insoluble oxalate pool, which was compared with the histopathological changes observed in iliac crest biopsy specimens. Go od correlation was observed between the histopathological grade of bon e oxalosis and the estimated oxalate content of the body. In the end-s tage of oxalate bone disease, hyperparathyroidism does not play a sign ificant role in bone resorption, which appears to be the consequence o f the granulomatous reaction induced by oxalate deposition. Combined l iver-kidney transplantation should be performed long before this stage . Early hepatorenal grafting in uremia secondary to primary hyperoxalu ria type 1 would avoid the deleterious clinical consequences of system ic oxalosis and shorten the duration of postransplant hyperoxaluria, w hich may compromise the course of kidney graft.