Hypercoagulability risks among adult living liver donors

Area of Science:

• Transplant Surgery
• Hepatology
• Coagulation Science

Background:

• Limited literature exists on thrombotic risk in living liver donors.
• Liver donation surgery involves significant physiological changes.
• Understanding coagulable changes is crucial for donor safety.

Purpose of the Study:

• To examine inherent coagulable changes in living liver donors post-surgery.
• To assess the impact of liver donation on key coagulation factors.
• To identify potential thrombotic risks associated with these changes.

Main Methods:

• Prospective monitoring of eight adult-to-adult living liver donors.
• Preoperative and postoperative measurement of protein C, protein S, antithrombin III, and factor VIII levels.
• Coagulation factor levels assessed at 48 hours, 2, 4, and 6 weeks post-donation.

Main Results:

• Significant postoperative decreases in protein C (to 0-29%), protein S (3-40%), and antithrombin III (47-55%) within 48 hours.
• Marked increase in factor VIII levels (>200%) post-surgery.
• All coagulation markers normalized within 4 to 6 weeks; no thromboembolic events occurred.

Conclusions:

• Post-liver donation surgery induces a temporary prothrombotic state characterized by low anticoagulant factors and high procoagulant factors.
• This coagulation imbalance may represent an independent risk factor for thrombosis.
• Further research is warranted to explore this phenomenon and its clinical implications for living liver donors.