Peripheral nerves regenerated in familial amyloid polyneuropathy after liver transplantation

Background: Liver transplantation holds promise as a treatment for familial amyloid polyneuropathy Objective: To determine whether peripheral nerves regenerate in patients with familial amyloid polyneuropathy after liver transplantation. Design: Case report. Setting: University hospital in Matsumoto, Japan. Patient: A 34-year-old woman with familial amyloid polyneuropathy who had liver transplantation and showed marked clinical improvement 3 years after surgery. Measurements: Histopathologic examination and morphometric analysis of biopsy specimens taken from sural nerves. Results: Diffuse fiber loss and amyloid deposits were seen in a biopsy specimen of the left sural nerve obtained before liver transplantation (total number of myelinated fibers, 1326/mm(2) of the endoneurial area). In the biopsy specimen of the right sural nerve, which was obtained 3 years after transplantation. amyloid deposits remained but the number of myelinated fibers was markedly increased (total number of myelinated fibers, 4740/mm(2)). Conclusion: Peripheral nerves regenerated in a patient with familial amyloid polyneuropathy after liver transplantation.