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: Tb2325@columbia.edu).
The authors report no conflicts of interest.