# Successful Pregnancy After Combined Liver and Renal Transplantation in a Patient With Acute Intermittent Porphyria

## TL;DR

A patient with a rare metabolic disorder successfully had a combined liver and kidney transplant and later gave birth to a healthy baby.

## Contribution

This case report demonstrates successful combined liver and renal transplantation in a patient with acute intermittent porphyria.

## Key findings

- The patient recovered well after combined liver and renal transplantation.
- She delivered a premature baby who developed normally over five years.
- This is only the third documented case of successful combined transplantation for this condition.

## Abstract

Acute intermittent porphyria is a rare inborn disease of porphyrin metabolism which can cause severe abdominal pain attacks and neurological symptoms. Here, we report a patient with a 20-year history of severe chronic manifestations of acute intermittent porphyria that led to end-stage renal disease and liver function impairment. Since only transplants can cure both disease manifestations, a combined liver and renal transplantation was performed. The patient recovered so well that she delivered a very low birth extreme premature baby 16 months later which developed normally over the next 5 years. Our case represents the third case in the literature with a successful combined liver/renal transplantation of a patient with acute porphyria. Thus, transplantation seems to be a viable backup option, should novel therapies such as siRNA treatment with givosiran fail.