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In both cases the metabolic liver functions recovered within the 12 postoperative hours; no clinical symptoms of propionic acid toxicity, metabolic acidosis, severe hyperammonaemia, hyperglycinaemia or haematological abnormalities were observed. In both cases insulin\u2010dependent diabetes mellitus occurred early after OLT (persisting in the boy's case). Severe post\u2010transplantation complications were observed (acute rejection and CMV infection in both patients) which did not trigger metabolic decompensation. The boy developed chronic rejection and vanishing bile duct syndrome due to incomplete hepatic arterial thrombosis. He required permanent in\u2010patient care with chronic hyperammonaemia and neurological sequelae involving the basal ganglia and died 15 months after OLT. The girl left hospital after 2 months and is presently leading a normal life with almost no dietary protein restriction (40g protein per day). Urinary urea excretion and daily protein intake increased after liver transplantation. Propionyl\u2010 and tiglylglycine disappeared immediately after OLT. Urinary methylcitrate and 3\u2010hydroxypropionate remained at concentrations corresponding to those before OLT. However, the total of all characteristic metabolites of organic acid analysis was reduced to 50\u201360% of the values before OLT in both patients. Propionylcarnitine was still detected at significant concentrations. Plasma odd\u2010chain fatty acid concentrations decreased continuously after OLT only in the girl's case. Tissue of both transplanted livers showed increased odd\u2010chain fatty acid concentrations 9 and 15 months after OLT, respectively, in both patients. We consider that at present OLT should only be performed in severe forms of propionic acidaemia.<\/jats:p>","DOI":"10.1007\/bf00710056","type":"journal-article","created":{"date-parts":[[2004,11,30]],"date-time":"2004-11-30T18:52:45Z","timestamp":1101840765000},"page":"448-461","source":"Crossref","is-referenced-by-count":39,"title":["Liver transplantation in two cases of propionic acidaemia"],"prefix":"10.1002","volume":"18","author":[{"given":"J. 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