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New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
Published on: June 27, 2025
Thromboembolic risk assessment in a phenotypically cured factor-V-Leiden carrier after orthotopic liver
Julian Strobel1, Juergen Ringwald, Robert Zimmermann
1Department of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Erlangen, Germany. julian.strobel@uk-erlangen.de
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 anticoagulation 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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