Iatrogenic amyloid polyneuropathy after domino liver transplantation

Table 2 Evaluation and monitoring of possible de novo amyloidosis after domino liver transplantation

Clinical presentation	Signs and symptoms	Testing
Dysautonomia (small fiber neuropathy)	Orthostatic hypotension	Tilt table testing
	Sweating abnormalities (anhidrosis)	QSART with autonomic battery
	Constipation/diarrhea	ECG
	Erectile dysfunction	Neurologic examination
	Neuropathic pain
	Arrhythmia
	Neurogenic bladder
Large fiber polyneuropathy	Sensory loss	EMG/NCS
	Weakness	Nerve (and muscle) biopsy
	Neuropathic pain	Neurologic examination
	Ataxia
	Areflexia
Cardiac amyloidosis	Fatigue	ECG
	Arrhythmia	Transthoracic echo
	Syncope	Radionuclide imaging
	Orthostatic hypotension	Cardiac MRI
		Endomyocardial biopsy
		BNP/troponin
Gastrointestinal amyloidosis	Constipation/diarrhea	GI tract biopsy
	Nausea/vomiting
Ocular amyloidosis	Dry eye	Ophthalmologic evaluation
	Vitreous opacity
	Glaucoma
Leptomeningeal amyloidosis	Cerebral infarction/hemorrhage	MRI of brain and spinal cord
	Hydrocephalus	Meningeal biopsy
	Ataxia
	Spastic paresis
	Seizures
	Dementia
Other system involvement	Coldness	Rectal and abdominal fat biopsy
	Weight loss	Salivary gland biopsy
	Peripheral edema	TSH
	Anemia	Urinalysis/urine protein collection
	Dry mouth

QSART: Quantitative sudomotor axon reflex test; ECG: Electrocardiograph; EMG/NCS: Electromyography and nerve conduction studies; MRI: Magnetic resonance imaging; BNP: Brain natriuretic peptide; GI: Gastrointestinal; TSH: Thyroid stimulating hormone.