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Living donor liver transplantation from an asymptomatic donor with mild coagulation factor IX deficiency: Report of a case
Author(s) -
Sanada Yukihiro,
Sasanuma Hideki,
Sakuma Yasunaru,
Morishima Kazue,
Kasahara Naoya,
Kaneda Yuji,
Miki Atsushi,
Fujiwara Takehito,
Shimizu Atsushi,
Hyodo Masanobu,
Hirata Yuta,
Yamada Naoya,
Okada Noriki,
Ihara Yoshiyuki,
Urahashi Taizen,
Madoiwa Seiji,
Mimuro Jun,
Mizuta Koichi,
Yasuda Yoshikazu
Publication year - 2014
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12358
Subject(s) - medicine , asymptomatic , coagulation , surgery , living donor liver transplantation , biliary atresia , liver transplantation , factor ix , transplantation , coagulation testing , gastroenterology
The use of donors with coagulation FIX deficiency is controversial, and there are no current protocols for peri‐transplant management. We herein describe the first reported case of a pediatric LDLT from an asymptomatic donor with mild coagulation FIX deficiency. A 32‐yr‐old female was evaluated as a donor for her 12‐month‐old daughter with biliary atresia. The donor's pretransplant coagulation tests revealed asymptomatic mild coagulation FIX deficiency ( FIX activity 60.8%). Freeze‐dried human blood coagulation FIX concentrate was administered before the dissection of the liver and 12 h afterwards by bolus infusion (40 U/kg) and was continued on POD 1. The bleeding volume at LDLT was 590 mL. On POD 1, 3, 5, and 13, the coagulation FIX activity of the donor was 121.3%, 130.6%, 114.6%, and 50.2%, respectively. The donor's post‐transplant course was uneventful, and the recipient is currently doing well at 18 months after LDLT . The FIX activity of the donor and recipient at nine months after LDLT was 39.2% and 58.0%, respectively. LDLT from donors with mild coagulation FIX deficiency could be performed effectively and safely using peri‐transplant short‐term coagulation FIX replacement and long‐term monitoring of the plasma FIX level in the donor.