Background: In the environment of organ shortage living-related sequential liver and kidney transplantation (SLKTx) from the same donor has emerged as a reasonable therapeutic alternative. We found in the literature only 8 cases of SLKTx for primary hyperoxaluria type 1 (PH1), the largest series comprised of 3 cases and all excluding one case were done in infants or small children (table). Hereby, we present our experience with 2 young adults who received SLKTx in PH1. Case reports:First case - SLKTx (interval between procedures 4.5 months) from a 47 y/o father to a 19 y/o son who suffered from PH1with nephrocalcinosis and was on dialysis for 2 years. Both the donor and the recipient had an uneventful post -operative course following Rt. liver lobe transplantation and kidney transplantation albeit re-exploration for control of bleeding in the recipient after liver transplantation. At 30 months after kidney transplantation the patient has normal liver and renal allograft function. Second case - SLKTx (interval 22 days) from a 44 y/o father to a 19 y/o daughter who suffered from PH1with nephrocalcinosis and was on dialysis for 8 months. Donor liver Rt. lobectomy was complicated by percutaneous subphrenic fluid collection which was drained percutaneously and completely resolved. The recipient procedures including Rt. liver lobe transplantation and kidney transplantation were uneventful. At 10 months after kidney transplantation the recipient's liver and renal allograft function are normal. Conclusions: In view of severe organ shortage, sequential living related liver-kidney transplantation should be carefully considered for young adults with PH1Table: [sequential combined liver-kidney transplantation]