Acquired factor V inhibitor after liver transplantation.
Acquired inhibitors against coagulation factor V (FV) occur rarely, the clinical symptoms vary to a great extent, from asymptomatic laboratory abnormalities to life-threatening bleeding. Coagulation factor V (FV) is a plasma-cofactor mostly existing in the plasma, and approximately 20-25% (Tracy et al. (1982), Kane (2006)) of FV exist in platelet granules. Patients' reaction is the prolonging of prothrombin time (PT) and activated partial thromboplastin time (APTT), but there is no exact reason, and that can not be corrected after normal plasma transfusion (Morris and Curris (2009), Lucia and Aguilar (2005)). We report here a case of the occurrence of FV inhibitors after orthotopic liver transplantation (OLT). With gastrointestinal bleeding, patient's haemostatic response was not achieved after using fresh frozenplasma (FFP), platelet concentrates (PC), prothrombin complex concentrates (PCC) or recombinant activated FVII (rFVIIa). After using high-dose intravenous immunoglobulin (IVIg) and change of immunosuppressant from tacrolimus (FK506) to cyclosporine, the bleeding stopped and better laboratory examination results was achieved thereafter.
Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, XiCheng District, Beijing 100050, People's Republic of China.
Li-Ying
LY
Sun
Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, XiCheng District, Beijing 100050, People's Republic of China. Electronic address: zhu-zhijun@medmail.com.cn.
Zhi-Jun
ZJ
Zhu
Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, XiCheng District, Beijing 100050, People's Republic of China.
Zhi-Gui
ZG
Zeng
Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, XiCheng District, Beijing 100050, People's Republic of China.
Wei
W
Qu
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianiin, 300020, China.
Lei
L
Zhang
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianiin, 300020, China.
Meng-Su
MS
Tian
Organ Transplantation Center, Tianjin First Center Hospital, 24 Fukang Road, Nankai, Tianjin 300192, People's Republic of China.
Xiao-Ye
XY
Sun
Organ Transplantation Center, Tianjin First Center Hospital, 24 Fukang Road, Nankai, Tianjin 300192, People's Republic of China.
Wei
W
Rao
Organ Transplantation Center, Tianjin First Center Hospital, 24 Fukang Road, Nankai, Tianjin 300192, People's Republic of China.
Wei
W
Gao
Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, XiCheng District, Beijing 100050, People's Republic of China.
Lin
L
Wei
D019774:Blood Coagulation Factor Inhibitors; D005165:Factor V; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*
D019774:Blood Coagulation Factor Inhibitors; D005165:Factor V