title: Outcome of liver transplantation for haemophilia.
abstract: BACKGROUND
  Prior to routine screening of blood products many patients with haemophilia were infected with hepatitis C virus (HCV) and have subsequently gone on to develop end-stage liver disease (ESLD).
  
  
  METHODS
  We report our experience of liver transplantation (LT) in patients with haemophilia that developed ESLD secondary to HCV. Patients transplanted from 1994 to 2008 were identified retrospectively. Patient demographics pre-, intra- and post-operative details and outcome were documented.
  
  
  RESULTS
  A total of 3800 LT were performed of which 13 had haemophilia A, 4 haemophilia B and one factor (F)X deficiency. All patients were male with a median age of 52 years (range 26-59), all were HCV antibody positive, 5 (28%) were human immunodeficiency virus (HIV) positive and 4 (22%) had hepatocellular carcinoma. Median intra-operative blood loss was 4.2 l (range 0.8-12) and all received coagulation factor support peri-operatively. Coagulation was unsupported by 72 h post-operatively in all recipients. Two patients developed complications as a result of post-operative bleeding. At a median follow-up of 90 months, 8 patients have died, including 4 of the 5 patients that were HIV positive. The median survival of patients with and without HIV co-infection was 26 and 118 months, respectively.
  
  
  CONCLUSIONS
  LT in patients with haemophilia cures the coagulation disorder and in the absence of HIV/HCV co-infection is associated with long-term patient survival.
authors.affiliation: King's College London School of Medicine at King's College Hospital, Institute of Liver Studies, King's College Hospital, Denmark Hill, London, UK.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Adam
authors.initials: A
authors.lastname: Bartlett
authors.forename: Faisal S
authors.initials: FS
authors.lastname: Dar
authors.forename: Michael
authors.initials: M
authors.lastname: Heneghan
authors.forename: John
authors.initials: J
authors.lastname: O'Grady
authors.forename: Mohamed
authors.initials: M
authors.lastname: Rela
authors.forename: Nigel
authors.initials: N
authors.lastname: Heaton
mesh_terms: D000328:Adult; D001777:Blood Coagulation; D005500:Follow-Up Studies; D006467:Hemophilia A / Q000097:blood / Q000150:complications / Q000601:surgery*; D006801:Humans; D017093:Liver Failure / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome