title: Recurrent deep-vein thrombosis based on homozygous factor V Leiden mutation acquired after liver transplantation.
abstract: Several genetic liver diseases can be treated by liver transplantation (LT). However, some genetic defects also may be acquired by this procedure. We describe a patient who developed recurrent deep-vein thromboses after LT for hepatitis C virus-associated hepatocellular carcinoma on the basis of a homozygous Leiden mutation of the factor V gene in the donor liver. Liver donors with a history of venous thrombosis should be screened for the presence of activated protein C (APC) resistance. In addition, we recommend looking for APC resistance in liver recipients who develop venous thromboembolic disease in the post-LT course. Molecular analysis of donor tissue may be necessary to make a definite diagnosis of factor V Leiden mutation in these patients. As a consequence, intensified postoperative thromboprophylaxis or lifelong anticoagulant therapy may be necessary if this thrombophilic gene defect is detected.
authors.affiliation: Department of Hepatobiliary Surgery, University Hospital Eppendorf, Hamburg, Germany. mwillems@uke.uni-hamburg.de
authors.forename: Marc
authors.initials: M
authors.lastname: Willems
authors.forename: Martina
authors.initials: M
authors.lastname: Sterneck
authors.forename: Florian
authors.initials: F
authors.lastname: Langer
authors.forename: Roman
authors.initials: R
authors.lastname: Jung
authors.forename: Munif
authors.initials: M
authors.lastname: Haddad
authors.forename: Christian
authors.initials: C
authors.lastname: Hagel
authors.forename: Robert
authors.initials: R
authors.lastname: Kuetemeier
authors.forename: Barbara
authors.initials: B
authors.lastname: Eifrig
authors.forename: Dieter
authors.initials: D
authors.lastname: Broering
authors.forename: Lutz
authors.initials: L
authors.lastname: Fischer
authors.forename: Xavier
authors.initials: X
authors.lastname: Rogiers
mesh_terms: D020016:Activated Protein C Resistance / Q000209:etiology; D000925:Anticoagulants / Q000627:therapeutic use; D005165:Factor V / Q000235:genetics*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008875:Middle Aged; D010644:Phenprocoumon / Q000627:therapeutic use; D012008:Recurrence; D020246:Venous Thrombosis / Q000209:etiology*
chemical_list: D000925:Anticoagulants; C095381:factor V Leiden; D005165:Factor V; D010644:Phenprocoumon