title: Factor XII deficiency acquired by orthotopic liver transplantation: case report and review of the literature.
abstract: Transmission of congenital clotting factor deficiencies after orthotopic liver transplantation is rare. There are published reports of liver donor-to-recipient transmission of protein C deficiency with dysfibrinogenemia, protein S, factor VII and factor XI deficiencies. We report a case of transmission of factor XII deficiency with liver transplantation in a patient with Budd-Chiari syndrome. There was a persistent elevation of the activated partial thromboplastin time (aPTT), but no evidence of bleeding while the patient was maintained on warfarin. The presence of a persistently abnormal aPTT may raise suspicion for the presence of a clotting factor deficiency; however, deficiencies of other clotting factors may not be readily apparent on routine blood tests performed in a donor. Being aware of the possibilities of transmission of these inherited deficiencies of coagulation factors will aid in their early detection and management in the transplant donor and recipient.
authors.affiliation: Transplant Center, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors.forename: N K
authors.initials: NK
authors.lastname: Osborn
authors.forename: Y
authors.initials: Y
authors.lastname: Ustundag
authors.forename: C S
authors.initials: CS
authors.lastname: Zent
authors.forename: R H
authors.initials: RH
authors.lastname: Wiesner
authors.forename: C B
authors.initials: CB
authors.lastname: Rosen
authors.forename: K V
authors.initials: KV
authors.lastname: Narayanan Menon
mesh_terms: D003937:Diagnosis, Differential; D005175:Factor XII Deficiency / Q000209:etiology* / Q000473:pathology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time