Amyloid polyneuropathy in 2 patients after liver transplantation.

Domino liver transplantation, in which the liver from a patient with transthyretin-mediated amyloidosis (ATTR) is transplanted into another patient, is a well-established procedure. The figure is from 2 unrelated cases of liver transplant receptors from donors with ATTR who developed clinical polyneuropathy with weakness and paresthesia in lower extremities some years after the liver transplantation. In both cases, EMG showed distal sensory and motor polyneuropathy. Although amyloid neuropathy was the clinical suspicion, a muscle and nerve biopsy was performed in order to rule out other conditions.