Orthotopic liver transplantation for hepatitis C infection: the best Christmas present?

Area of Science:

• Hepatology
• Hematology
• Transplantation

Background:

• Christmas disease (hemophilia B) is a rare genetic bleeding disorder caused by a deficiency in coagulation Factor IX.
• Patients with hemophilia B may receive coagulation factor concentrates for treatment.
• Chronic hepatitis C infection can lead to severe liver disease, including liver failure.

Observation:

• A 60-year-old man with mild Christmas disease (Factor IX 10%) contracted chronic hepatitis C from factor concentrates.
• The patient subsequently developed hepatic encephalopathy and liver failure, necessitating liver transplantation.
• Post-transplantation, the patient experienced a rapid normalization of Factor IX levels.

Findings:

• Liver transplantation effectively resolved the Factor IX deficiency in this patient with Christmas disease.
• The normalization of Factor IX levels post-transplantation suggests a phenotypic cure of the hemophilia B.

Implications:

• Liver transplantation may represent a potential therapeutic strategy for severe liver complications in hemophilia B patients.
• This case highlights the complex interplay between inherited bleeding disorders, viral infections, and organ transplantation.
• Further research is warranted to explore the mechanisms underlying Factor IX normalization after liver transplantation in hemophilia B.