TY - JOUR T1 - Systemic but asymptomatic transthyretin amyloidosis 8 years after domino liver transplantation JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 1287 LP - 1290 DO - 10.1136/jnnp.2010.218958 VL - 82 IS - 11 AU - Haruki Koike AU - Tetsuya Kiuchi AU - Masahiro Iijima AU - Mitsuharu Ueda AU - Yukio Ando AU - Saori Morozumi AU - Minoru Tomita AU - Yuichi Kawagashira AU - Hirohisa Watanabe AU - Masahisa Katsuno AU - Yoshie Shimoyama AU - Yasumasa Okazaki AU - Hideya Kamei AU - Gen Sobue Y1 - 2011/11/01 UR - http://jnnp.bmj.com/content/82/11/1287.abstract N2 - As familial amyloid polyneuropathy (FAP) is an adult-onset disease, a long period is expected between domino liver transplantation (DLT) and the occurrence of amyloidosis in recipients of a FAP liver. However, as time passes, and increased numbers of patients have undergone DLT, patients with symptoms suggesting amyloidosis have been reported. The authors describe, for the first time, pathological findings in an autopsy case of a recipient of a FAP liver. A male patient with primary sclerosing cholangitis received a liver graft from a FAP patient with the transthyretin (TTR) Tyr114Cys mutation when he was 30 years old. Although a recurrence of primary sclerosing cholangitis was detected at age 34, he had no symptoms indicating amyloidosis. He died from Burkitt's lymphoma at 38 years of age. TTR immunoreactive amyloid was found in various organs including the heart, lung, gastrointestinal tract, pancreas, spleen, reproductive system and skeletal muscles. In the nervous system, TTR immunoreactive amyloid deposition was obvious in the sympathetic ganglia and the median nerve within the carpal tunnel, while loss of neurons or nerve fibres was not apparent. This case allows for the characterisation of amyloid deposition during the asymptomatic stage of FAP. Widespread amyloid deposition may occur before tissue damage in this disease. ER -