Liver transplantation for glycogen storage disease types I, III, and IV

D. Matern, T. E. Starzl, W. Arnaout, J. Barnard, J. S. Bynon, A. Dhawan, J. Emond, E. B. Haagsma, G. Hug, A. Lachaux, G. P.A. Smit, Y. T. Chen

Research output: Contribution to journalArticle

134 Scopus citations

Abstract

Glycogen storage disease (GSD) types I, III, and IV can be associated with severe liver disease. The possible development of hepatocellular carcinoma and/or hepatic failure make these GSDs potential candidates for liver transplantation. Early diagnosis and initiation of effective dietary therapy have dramatically improved the outcome of GSD type I by reducing the incidence of liver adenoma and renal insufficiency. Nine type 1 and 3 type III patients have received liver transplants because of poor metabolic control, multiple liver adenomas, or progressive liver failure. Metabolic abnormalities were corrected in all GSD type I and type III patients, while catch-up growth was reported only in two patients. Whether liver transplantation results in reversal and/or prevention of renal disease remains unclear. Neutropenia persisted in both GSDIb patients post liver transplantation necessitating continuous granulocyte colony stimulating factor treatment. Thirteen GSD type IV patients were liver transplanted because of progressive liver cirrhosis and failure. All but one patient have not had neuromuscular or cardiac complications during follow-up periods for as long as 13 years. Four have died within a week and 5 years after transplantation. Caution should be taken in selecting GSD type IV candidates for liver transplantation because of the variable phenotype, which may include life-limiting extrahepatic manifestations. It remains to be evaluated, whether a genotype-phenotype correlation exists for GSD type IV, which may aid in the decision making. Conclusion: Liver transplantation should be considered for patients with glycogen storage disease who have developed liver malignancy or hepatic failure, and for type IV patients with the classical and progressive hepatic form.

Original languageEnglish (US)
Pages (from-to)S43-S48
JournalEuropean Journal of Pediatrics, Supplement
Volume158
Issue number2
StatePublished - Nov 29 1999

Keywords

  • Glycogen storage disease
  • Kidney transplantation
  • Liver transplantation
  • Tube feeding
  • Uncooked cornstarch

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Matern, D., Starzl, T. E., Arnaout, W., Barnard, J., Bynon, J. S., Dhawan, A., Emond, J., Haagsma, E. B., Hug, G., Lachaux, A., Smit, G. P. A., & Chen, Y. T. (1999). Liver transplantation for glycogen storage disease types I, III, and IV. European Journal of Pediatrics, Supplement, 158(2), S43-S48.