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Rapidly Progressive Transthyretin-Mediated Amyloidosis in a Domino Liver Transplant Recipient of a Ser23Asn Donor

Dixit, Neel MD; Castano, Adam MD; Farr, Mary Jane MD; Traub, Rebecca MD; Lentzsch, Suzanne MD, PhD; Brown, Robert S. Jr MD, MPH; Maurer, Mathew S. MD; Brannagan, Thomas H. III MD

Journal of Clinical Neuromuscular Disease: March 2016 - Volume 17 - Issue 3 - p 142–145
doi: 10.1097/CND.0000000000000110
Case Review

Domino liver transplantation, in which the liver of a patient with transthyretin-mediated amyloidosis is transplanted into another patient, has been an established procedure performed at several centers across the world. The risk of developing systemic amyloidosis in transthyretin-mediated amyloidosis liver transplant recipients is a topic of ongoing investigation. We report a case of rapidly progressive transthyretin amyloidosis in a patient who received a liver from a donor with a rare Ser23Asn mutation. We advise exercising caution when considering domino liver transplantation in patients with this particular mutation.

*Peripheral Neuropathy Center, Neurological Institute;

Departments of Cardiology;

Hematology and Oncology; and

§Gastroenterology, Columbia University, College of Physicians and Surgeons, New York, NY.

Reprints: Thomas H. Brannagan III, MD, Peripheral Neuropathy Center, Neurological Institute, Columbia University, College of Physicians and Surgeons, 710 W, 168th St, Box 163, NY 10032 (e-mail:

The authors report no conflicts of interest.

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