Liver transplant in ethylmalonic encephalopathy: A new treatment for an otherwise fatal disease

Carlo Dionisi Vici, Daria Diodato, Giuliano Torre, Stefano Picca, Rosanna Pariante, Sergio Giuseppe Picardo, Ivano Di Meo, C. Rizzo, Valeria Sonia Tiranti, Massimo Zeviani, Jean De Ville De Goyet

Research output: Contribution to journalArticle

Abstract

Ethylmalonic encephalopathy is a fatal, rapidly progressive mitochondrial disorder caused by ETHE1 mutations, whose peculiar clinical and biochemical features are due to the toxic accumulation of hydrogen sulphide and of its metabolites, including thiosulphate. In mice with ethylmalonic encephalopathy, liver-targeted adeno-associated virus-mediated ETHE1 gene transfer dramatically improved both clinical course and metabolic abnormalities. Reasoning that the same achievement could be accomplished by liver transplantation, we performed living donor-liver transplantation in an infant with ethylmalonic encephalopathy. Unlike the invariably progressive deterioration of the disease, 8 months after liver transplantation, we observed striking neurological improvement with remarkable achievements in psychomotor development, along with dramatic reversion of biochemical abnormalities. These results clearly indicate that liver transplantation is a viable therapeutic option for ETHE1 disease.

Original languageEnglish
Pages (from-to)1045-1051
Number of pages7
JournalBrain
Volume139
Issue number4
DOIs
Publication statusPublished - Apr 1 2016

Keywords

  • ethylmalonic encephalopathy
  • liver transplant
  • mitochondrial disorders treatment

ASJC Scopus subject areas

  • Clinical Neurology

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    Dionisi Vici, C., Diodato, D., Torre, G., Picca, S., Pariante, R., Giuseppe Picardo, S., Di Meo, I., Rizzo, C., Tiranti, V. S., Zeviani, M., & De Goyet, J. D. V. (2016). Liver transplant in ethylmalonic encephalopathy: A new treatment for an otherwise fatal disease. Brain, 139(4), 1045-1051. https://doi.org/10.1093/brain/aww013