Severe thrombotic complications associated with activated protein C resistance acquired by orthotopic liver transplantation

We report a patient who developed recurrent hepatic artery thrombosis and d eep venous thrombosis following orthotopic liver transplantation. Investiga tions revealed the presence of activated protein C (APC) resistance due to a mutation in the factor V gene in the transplanted liver, The patient's ow n peripheral blood cells did not carry the mutation. Although part of facto r V is located in the platelets and may be endogenously synthesized by mega karyocytes, this case demonstrates the major clinical importance of hepatic -derived factor V, It may be reasonable to screen liver donors with a histo ry of a thrombotic event for APC, and to consider anticoagulation in the re cipients of livers positive for this defect. Copyright (C) 2001 S.Karger AG , Basel.