THE ROLE OF PREOPERATIVE FACTOR-V-LEIDEN SCREENING IN DIFFERENT GEOGRAPHIC POPULATIONS

Patients harboring a specific mutation in the coagulation factor V gen e have been identified as being at significantly increased risk for ve nous thrombosis. A simple genetic test that identifies carriers of thi s mutation (the factor V Leiden allele) is available and may have util ity in various clinical settings, including preoperative risk assessme nt for thromboembolic complications. In this regard, it is generally a greed that prospective studies addressing the role of preoperative fac tor V Leiden mutational analysis are needed to clearly define the clin ical prognostic/diagnostic significance of the presence of this mutati on in surgical patients. This report questions the role that populatio n dynamics (genetic and environmental backgrounds of individual popula tions) plays in the analysis of factor V genotypic data in relation to postsurgical thromboembolic complications. We have determined that th e frequency of individuals carrying the factor V Leiden allele is 7.9 per cent for our South Central Pennsylvania population (395 wild type, 32 heterozygotes, 2 homozygotes) using a polymerase chain reaction-re striction fragment length polymorphism technique that specifically det ects the factor V Leiden mutation. This baseline population informatio n is useful from both a clinical and a basic science viewpoint. Howeve r, considering the various unknown genetic and environmental differenc es between geographically distinct populations, the significance of th is result, in terms of clinical management of our surgical patients, i s yet to be determined.