Acquired factor XI deficiency: a rare complication after liver transplantation

Y Yankol; N Mecit; T Kanmaz; K Acarli; M Kalayoglu

doi:10.1016/j.transproceed.2014.10.042

Acquired factor XI deficiency: a rare complication after liver transplantation

Transplant Proc. 2015 Jan-Feb;47(1):179-81. doi: 10.1016/j.transproceed.2014.10.042. Epub 2015 Jan 14.

Authors

Y Yankol¹, N Mecit², T Kanmaz², K Acarli², M Kalayoglu²

Affiliations

¹ Organ Transplantation Center, Sisli Memorial Hospital, Istanbul, Turkey. Electronic address: yyankol@yahoo.com.
² Organ Transplantation Center, Sisli Memorial Hospital, Istanbul, Turkey.

PMID: 25596963
DOI: 10.1016/j.transproceed.2014.10.042

Abstract

Background: A majority of coagulation factors are synthesized in the liver. Factor XI (FXI) deficiency (Rosenthal syndrome) is one of the rare inherited coagulation disorders with an extremely low risk of transmission by liver transplantation (LT).

Case report: We report here the case of a 50-year-old man who unknowingly acquired FXI deficiency by LT. During 1 year of post-transplant follow-up, his activated partial thromboplastin time (aPTT) remained prolonged, but he did not develop bleeding complications. The patient required retransplantation due to chronic rejection and is currently doing well 4 years after his first liver transplantation.

Conclusions: The presence of a prolonged aPTT in a deceased donor should raise suspicion for the presence of rare coagulation factor deficiencies. During urgent, lifesaving procedures such as LT, it may be impossible to avoid transmission. Awareness of this possibility will allow early detection and management.

Publication types

Case Reports

MeSH terms

End Stage Liver Disease / diagnosis
End Stage Liver Disease / etiology
End Stage Liver Disease / surgery*
Factor XI Deficiency / diagnosis*
Factor XI Deficiency / etiology*
Factor XI Deficiency / therapy
Humans
Liver Transplantation / adverse effects*
Male
Middle Aged
Partial Thromboplastin Time
Reoperation
Risk Factors