{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:58:16Z","timestamp":1787698696419,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,20]],"date-time":"2021-03-20T00:00:00Z","timestamp":1616198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Combined liver\u2013kidney transplantation is a therapeutic option for children affected by type 1 primary hyperoxaluria. Persistently high plasma oxalate levels may lead to kidney graft failure. It is debated whether pre\u2010emptive liver transplantation, followed by kidney transplantation, might be a better strategy to reduce kidney graft loss. Our experience of 6 pediatric combined liver\u2013kidney transplants for primary hyperoxaluria type 1 in pediatric recipients was retrospectively analyzed. Plasma oxalate levels were monitored before and after transplantation. All the recipients were on hemodialysis at transplantation. Median [IQR] recipient's age at transplantation was 11 [1\u201314]\u00a0years; in all cases, a compatible graft from a pediatric brain\u2010dead donor aged 8 [2\u201316]\u00a0years was used. In a median follow\u2010up of 7 [2\u201319]\u00a0years after combined liver\u2013kidney transplantation, no child died and no liver graft failure was observed; three kidney grafts were lost, due to chronic rejection, primary non\u2010function, and early renal oxalate accumulation. Liver and kidney graft survival remained stable at 1, 3, and 5\u00a0years, at 100% and 85%, respectively. Kidney graft loss was the major complication in our series. Risk is higher with very young, low\u2010weight donors. The impact of treatment with glyoxalate pathway enzyme inhibitors treatment in children with advanced disease as well as of donor kidney preservation by ex vivo machine perfusion needs to be evaluated. At present, a case\u2010by\u2010case discussion is needed to establish an optimal treatment strategy.<\/jats:p>","DOI":"10.1111\/petr.14003","type":"journal-article","created":{"date-parts":[[2021,3,20]],"date-time":"2021-03-20T13:44:30Z","timestamp":1616247870000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Combined liver kidney transplantation for primary hyperoxaluria type 1: Will there still be a future? Current transplantation strategies and monocentric experience"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3166-6684","authenticated-orcid":false,"given":"Francesco","family":"Tandoi","sequence":"first","affiliation":[{"name":"General Surgery 2U and Liver Transplant Unit Department of Surgical Sciences A.O.U. Citt\u00e0 della Salute e della Scienza Molinette Hospital University of Torino Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3220-8995","authenticated-orcid":false,"given":"Davide","family":"Cussa","sequence":"additional","affiliation":[{"name":"General Surgery 2U and Liver Transplant Unit Department of Surgical Sciences A.O.U. 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