Acquired hemophilia A after liver transplantation: a case report.
It is well recognized that orthotopic liver transplantation rapidly corrects the coagulation disorder observed in patients with hemophilia A or B combined with end-stage liver disease; however, the transmission of hemophilia from a donor to a transplant recipient has not been reported previously. We describe a patient who developed acquired hemophilia A after liver transplantation due to the unknown presence of factor VIII inhibitor in the donor. The resulting coagulation disorder was unresponsive to standard factor replacement therapy, and was ultimately corrected with retransplantation. Hemophiliac donors should not be precluded from organ donation, though the presence of factor VIII inhibitor should be actively sought before organ procurement. High levels of factor VIII inhibitor represents an absolute contraindication to liver donation.
The Dumont-UCLA Transplant Center, Los Angeles, CA 90095-7054, USA.
Garrett M
GM
Hisatake
Teng-Wei
TW
Chen
John F
JF
Renz
Douglas G
DG
Farmer
R Mark
RM
Ghobrial
Hasan
H
Yersiz
Rafael G
RG
Amado
Leonard
L
Goldstein
Ronald W
RW
Busuttil
D005169:Factor VIII / Q000378:metabolism; D006467:Hemophilia A / Q000209:etiology*; D019698:Hepatitis C, Chronic / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D014019:Tissue Donors
D005169:Factor VIII