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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 28, 2017; 9(3): 126-130
Published online Jan 28, 2017. doi: 10.4254/wjh.v9.i3.126
Published online Jan 28, 2017. doi: 10.4254/wjh.v9.i3.126
Iatrogenic amyloid polyneuropathy after domino liver transplantation
Diana Mnatsakanova, Saša A Živković, Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States
Author contributions: Mnatsakanova D and Živković SA contributed equally to this work, generated the tables and wrote the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Saša A Živković, MD, PhD, Department of Neurology, University of Pittsburgh Medical Center, 3471 Fifth Ave #810, Pittsburgh, PA 15213, United States. zivkovics@upmc.edu
Telephone: +1-412-6471706 Fax: +1-412-6478398
Received: August 30, 2016
Peer-review started: September 1, 2016
First decision: September 29, 2016
Revised: October 14, 2016
Accepted: December 7, 2016
Article in press: December 9, 2016
Published online: January 28, 2017
Peer-review started: September 1, 2016
First decision: September 29, 2016
Revised: October 14, 2016
Accepted: December 7, 2016
Article in press: December 9, 2016
Published online: January 28, 2017
Core Tip
Core tip: Domino liver transplantation (DLT) has been used in treatment of transthyretin amyloidosis, with explanted liver being transplanted to another patient with liver failure as the liver is otherwise usually functionally normal. Domino liver explant recipients are at risk of developing de novo systemic amyloidosis and amyloid neuropathy has been described in up to 23% of transplant recipients after a median of 7 years following DLT. Typical initial symptoms include neuropathic pain and sensory loss, while dysautonomia usually starts later. Explant allograft recipients need close monitoring for signs of systemic amyloidosis, neuropathy and dysautonomia as progressive symptoms may require re-transplantation.