Recurrent deep-vein thrombosis based on homozygous factor V Leiden mutation acquired after liver transplantation.
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.
Willems
Marc
M
Department of Hepatobiliary Surgery, University Hospital Eppendorf, Hamburg, Germany. mwillems@uke.uni-hamburg.de
Sterneck
Martina
M
Langer
Florian
F
Jung
Roman
R
Haddad
Munif
M
Hagel
Christian
C
Kuetemeier
Robert
R
Eifrig
Barbara
B
Broering
Dieter
D
Fischer
Lutz
L
Rogiers
Xavier
X
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*
D000925:Anticoagulants; C095381:factor V Leiden; D005165:Factor V; D010644:Phenprocoumon