Thromboembolic Risk Assessment in a Phenotypically Cured Factor-V-Leiden Carrier after Orthotopic Liver Tr ansplantation
Strobel, J.; Ringwald, J.; Zimmermann, R.; Eckstein, R.
Clinical Laboratory 56(5-6): 245-247
2010
ISSN/ISBN: 1433-6510 PMID: 20575473 Document Number: 15701
Background: The factor V Leiden mutation is a common genetic risk factor for thromboembolism. After liver transplantation, patients may present with an acquired factor V phenotype – genotype discrepancy. Case report: We present the history of a heterozygous carrier of the factor V Leiden mutation who needed liver transplantation because of coumarin-induced acute liver failure. This led to a phenotype – genotype discrepancy with apparent cure from the factor V Leiden carrier status. Conclusions: To date the thromboembolic risk assessment regarding the need for postoperative prophylactic anti-coagulation in such patients has remained controversial with respect to the intracellular fraction of factor V in platelets. However, recent observations have shown that platelet factor V Leiden is endocytosed by megacaryocytes from plasma. Therefore, former assessments of an ongoing risk for thromboembolic events despite apparent cure of the factor V Leiden carrier status after liver transplantation should be corrected.
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