Advantages of isolated liver transplantation before kidney failure over combined liver-kidney transplantation afterwards. Oxalate excretion: Black line.

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Advantages of isolated liver transplantation before kidney failure over combined liver-kidney transplantation afterwards. Oxalate excretion: Black line = theoretical urinary excretion pattern before and after isolated liver transplantation in a patient who did not have compromised renal function; gray line = theoretical excretion pattern before and after combined liver-kidney transplantation in a patient who did have end-stage renal failure (ESRF). Total oxalate body burden: Black area = theoretical total accumulation of oxalate in the body in the former case; gray area = theoretical total accumulation of oxalate in the body in the latter case. Decreased oxalate excretion, and hence increased oxalate accumulation, during ESRF would be expected to lead much slower normalization of body oxalate levels and excretion following correction of the enzyme defect by liver transplantation than would occur if transplantation had been carried out before ESRF. Ordinate = amount; abscissa = time. Source: Primary Hyperoxaluria, The Online Metabolic and Molecular Bases of Inherited Disease Citation: Valle D, Beaudet AL, Vogelstein B, Kinzler KW, Antonarakis SE, Ballabio A, Gibson K, Mitchell G. The Online Metabolic and Molecular Bases of Inherited Disease; 2014 Available at: https://ommbid.mhmedical.com/DownloadImage.aspx?image=/data/books/971/ch133fg25.png&sec=62641796&BookID=971&ChapterSecID=62641527&imagename= Accessed: October 09, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved