title: Successful liver transplantation in a patient with splanchnic vein thrombosis and pulmonary embolism due to polycythemia vera with Jak2v617f mutation and heparin-induced thrombocytopenia.
abstract: Heparin-induced thrombocytopenia (HIT) is a rare complication of heparin treatment resulting in a severe acquired thrombophilic condition with an associated mortality of about 10 %. We report the first case of successful urgent liver transplantation (LT) in a patient with end-stage liver disease due to a Budd-Chiari syndrome, portal vein thrombosis and pulmonary embolism due to acquired thrombophilia associated to polycythemia vera carrying JAK2V617F gene mutation and HIT in the acute phase. Lepirudin was used to provide anticoagulation in the LT perioperative period that was performed without haemorrhagic and thrombotic complications despite the donor received heparin during liver explantation.
authors.affiliation: Surgical ICU, Anesthesia and Intensive Care Department, University Hospital of Modena, Modena, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Biagioni
authors.forename: Paola
authors.initials: P
authors.lastname: Pedrazzi
authors.forename: Marco
authors.initials: M
authors.lastname: Marietta
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Di Benedetto
authors.forename: Erica
authors.initials: E
authors.lastname: Villa
authors.forename: Mario
authors.initials: M
authors.lastname: Luppi
authors.forename: Massimo
authors.initials: M
authors.lastname: Girardis
mesh_terms: D019943:Amino Acid Substitution; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D006502:Budd-Chiari Syndrome / Q000150:complications / Q000201:enzymology / Q000235:genetics / Q000601:surgery; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D053614:Janus Kinase 2 / Q000235:genetics*; D016031:Liver Transplantation; D008875:Middle Aged; D020125:Mutation, Missense; D011087:Polycythemia Vera / Q000150:complications / Q000201:enzymology / Q000235:genetics / Q000601:surgery; D011655:Pulmonary Embolism / Q000150:complications / Q000201:enzymology / Q000235:genetics / Q000601:surgery; D013921:Thrombocytopenia / Q000139:chemically induced / Q000201:enzymology / Q000601:surgery; D020246:Venous Thrombosis / Q000150:complications / Q000201:enzymology / Q000235:genetics / Q000601:surgery
chemical_list: D000925:Anticoagulants; D006493:Heparin; C507924:JAK2 protein, human; D053614:Janus Kinase 2