MISC

2011年10月

Preoperative Dialysis for Liver Transplantation in Methylmalonic Acidemia

THERAPEUTIC APHERESIS AND DIALYSIS
  • Koichi Kamei
  • ,
  • Shuichi Ito
  • ,
  • Takanobu Shigeta
  • ,
  • Seisuke Sakamoto
  • ,
  • Akinari Fukuda
  • ,
  • Reiko Horikawa
  • ,
  • Osamu Saito
  • ,
  • Takashi Muguruma
  • ,
  • Satoshi Nakagawa
  • ,
  • Kazumoto Iijima
  • ,
  • Mureo Kasahara

15
5
開始ページ
488
終了ページ
492
記述言語
英語
掲載種別
DOI
10.1111/j.1744-9987.2011.00974.x
出版者・発行元
WILEY-BLACKWELL

Dialysis immediately before liver transplantation for patients with methylmalonic academia (MMA) with the mut0 mutation is considered to be necessary to reduce plasma methylmalonic acid (MMA) levels and prevent metabolic decompensation for a successful surgical outcome; however, this has not yet been conclusively confirmed. Ten pediatric patients underwent living donor liver transplantation at the National Center for Child Health and Development, Tokyo, Japan. Seven patients received dialysis immediately before surgery, but the three most recent patients did not receive dialysis. We monitored plasma MMA levels and evaluated metabolic status during the perioperative period. Plasma MMA levels of patients who received preoperative dialysis were significantly decreased. However, lactic acidosis developed in two patients during surgery. One of the patients who had decreased renal function suffered from severe lactic acidosis after the transplantation and died on post operative day 44. In the three patients who did not receive preoperative dialysis, high plasma MMA levels persisted, but they did not develop metabolic decompensation. Their plasma MMA levels gradually decreased after transplantation. Our results indicated that reducing MMA with preoperative dialysis does not decrease the risk of metabolic decompensation. We will need to evaluate whether preoperative dialysis is necessary for the success of surgery with more cases in the future. Adequate perioperative glucose infusion and careful lactate monitoring are pivotal for success.

Web of Science ® 被引用回数 : 19

リンク情報
DOI
https://doi.org/10.1111/j.1744-9987.2011.00974.x
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/21974703
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000295138900010&DestApp=WOS_CPL
URL
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=80053197801&origin=inward
ID情報
  • DOI : 10.1111/j.1744-9987.2011.00974.x
  • ISSN : 1744-9979
  • PubMed ID : 21974703
  • SCOPUS ID : 80053197801
  • Web of Science ID : WOS:000295138900010

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