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Published on: October 11, 2024
Von Willebrand Factor Deficiency Corrected by Lung Transplantation
Rafael Forés1, Ana Lario, Santiago Gil
11 Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. 2 Department of Thoracic Surgery, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. 3 Department of Pneumology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. 4 Department of Hematology, Hospital Universitario La Paz, Madrid, Spain.
Background:
In experimental models with von Willebrand disease pigs, plasma von Willebrand factor (vWF) was significantly increased after lung transplantation because lung endothelial cells strongly express vWF. However, these findings have not been confirmed in human beings.
Methods:
A 26-year-old man with mild vWF deficiency (FvW:antigen 39 IU/dL; FvW:ristocetin cofactor activity 44 IU/dL; factor VIII 99%; normal multimeric plasma vWF pattern) was referred to our institution and underwent bilateral lung transplantation for cystic fibrosis. The patient received factor VIII/vWF concentrate both during and after surgery without any relevant bleeding events. At hospital discharge, he was taking immunosuppression with oral tacrolimus, prednisone, and mycophenolate mofetil, which has continued until the present day (22 months after the procedure).
Results:
Plasma vWF level increased during the postoperative days, presumably due to endothelial injuries and the infusion of vWF concentrate. Laboratory tests at 5, 11, 14, and 22 months after lung transplantation demonstrated sustained normalization of all parameters.
Conclusions:
To our knowledge, this is the first reported case of von Willebrand deficiency corrected through lung transplantation.
