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Hyperhomocysteinemia and deep vein thrombosis in orthotopic heart transplantation: a case report

Alex Costea1, Geetha Bhat

  • 1Division of Cardiology, University of Louisville, Louisville, Kentucky, USA.

American Journal of Hematology
|September 25, 2004
PubMed

Insights

Elevated homocysteine levels in heart transplant recipients are linked to venous thrombosis. Treatment with vitamins and enoxaparin effectively reduced both high homocysteine and clotting risk in a case study.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Thrombosis Research

Background:

  • Homocysteine is a known risk factor for atherosclerosis and thrombosis.
  • Heart transplant recipients often exhibit hyperhomocysteinemia, potentially increasing cardiac allograft vasculopathy risk.
  • Limited data exists on the venous thrombosis risk associated with hyperhomocysteinemia in transplant patients.

Observation:

  • A 36-year-old heart transplant patient presented with no prior clotting history.
  • This patient exhibited elevated homocysteine levels and a hypercoagulable state.
  • Extensive venous thrombosis was diagnosed in the patient.

Findings:

  • The case report demonstrates a correlation between high homocysteine and hypercoagulable syndrome in a heart transplant recipient.
  • Both elevated homocysteine and venous thrombosis showed a rapid positive response to treatment.
  • Treatment involved a combination of folate, vitamin B12, vitamin B6, and enoxaparin.

Implications:

  • This case highlights the potential for elevated homocysteine to contribute to venous thrombosis in heart transplant patients.
  • Vitamin therapy combined with anticoagulation may be an effective strategy for managing hyperhomocysteinemia and thrombosis post-transplant.
  • Further research is warranted to explore the broader implications of homocysteine levels on thrombotic events in this population.

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