Combined Liver–Kidney Transplantation for Primary Hyperoxaluria Type 2: A Case Report

T. Dhondup, E. C. Lorenz, D. S. Milliner, J. C. Lieske

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Combined liver/kidney transplant is the preferred transplant option for most patients with primary hyperoxaluria type 1 (PH1) since orthotopic liver transplantation replaces the deficient liver-specific AGT enzyme, thus restoring normal metabolic oxalate production. However, primary hyperoxaluria type 2 (PH2) is caused by deficient glyoxylate reductase/hydroxypyruvate reductase (GRHPR), and this enzyme is widely distributed throughout the body. Though the relative abundance and activity of GRHPR in various tissues is not clear, some evidence suggests that the majority of enzyme activity may indeed reside within the liver. Thus the effectiveness of liver transplantation in correcting this metabolic disorder has not been demonstrated. Here we report a case of 44-year-old man with PH2, frequent stone events, and end-stage renal disease; he received a combined liver/kidney transplant. Although requiring confirmation in additional cases, the normalization of plasma oxalate, urine oxalate, and urine glycerate levels observed in this patient within a month of the transplant that remain reduced at the most recent follow-up at 13 months suggests that correction of the GRHPR deficiency in PH2 can be achieved by liver transplantation.

Original languageEnglish (US)
Pages (from-to)253-257
Number of pages5
JournalAmerican Journal of Transplantation
Issue number1
StatePublished - Jan 2018


  • clinical research/practice
  • kidney failure/injury
  • kidney transplantation/nephrology
  • liver biology
  • liver transplantation/hepatology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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