A literature review was performed to ascertain the outcomes associated with liver and or kidney transplantation in patients with propionic acidemia (PA) or methylmalonic acidemia (MMA).

Thirty-eight papers and 32 abstracts were identified, totalling 373 patients.

Transplantation improved outcome in some patients with PA and MMA, but was also associated with appreciable mortality (14% PA, 11% MMA) and complications including cardiomyopathy, hepatic arterial thrombosis, renal failure/impairment, and viral infections.

While transplantation appears to be of some benefit in a subset of patients with PA/MMA, this approach does not provide a metabolic cure and patients remain at risk from disease-related and transplantation-related complications.

All treatment avenues should ideally be exhausted for PA/MMA before selecting transplantation.