title: Successful Living-Related Renal Allograft in a Recipient With Factor V Leiden Deficiency: A Case Report.
abstract: Thrombophilia due to activated protein C resistance (Leiden mutation) is the most common inherited thrombophilic disorder with 5% incidence in whites. Renal transplant of these patients entails a risk of vascular thrombosis soon after the transplant; and acute rejection episodes and graft loss within the first year. We present a case of a successful living-related renal transplant in man with a recent history of repeat episodes of vascular access thrombosis attributed to inherited thrombophilia (heterozygosity for factor V mutation Q506 and homozygosity for mutation T677 for methylene-tetrahydrofolate reductase). Transplant recipient was administered anticoagulation therapy with low molecular weight heparin pre- and postoperatively. No thrombotic or hemorrhagic events occurred posttransplant. A high suspicion of thrombophilic disorders in patients with end-stage renal disease with vascular access thrombotic events should be screened further to prevent failure of a subsequent renal transplant. Inherited thrombophilic disorders may not exclude living-related kidney transplant provided that anticoagulation therapy is admin-istered perioperatively.
authors.affiliation: From the First Department of Surgery Transplant Unit, Evangelismos General Hospital of Athens, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Florou
authors.forename: Maria
authors.initials: M
authors.lastname: Koukoulaki
authors.forename: Theodoridis
authors.initials: T
authors.lastname: Theodoros
authors.forename: Vasileios
authors.initials: V
authors.lastname: Kalatzis
authors.forename: Vasileios
authors.initials: V
authors.lastname: Vougas
authors.forename: Elissavet
authors.initials: E
authors.lastname: Stamataki
authors.forename: Vasiliki Christopoulou
authors.initials: VC
authors.lastname: Kokkinou
authors.forename: Alkiviadis
authors.initials: A
authors.lastname: Kostakis
authors.forename: Spiros
authors.initials: S
authors.lastname: Drakopoulos
mesh_terms: D020016:Activated Protein C Resistance / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics*; D000368:Aged; D064591:Allografts; D000925:Anticoagulants / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects / Q000235:genetics*; D005165:Factor V / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D008875:Middle Aged; D010641:Phenotype; D017354:Point Mutation; D035781:Siblings; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; C095381:factor V Leiden; D005165:Factor V; C573423:MTHFR protein, human; D042965:Methylenetetrahydrofolate Reductase (NADPH2)