Skip to main content
Log in

Successful liver transplantation in a patient with splanchnic vein thrombosis and pulmonary embolism due to polycythemia vera with Jak2v617f mutation and heparin-induced thrombocytopenia

  • Published:
Journal of Thrombosis and Thrombolysis Aims and scope Submit manuscript

Abstract

Heparin-induced thrombocytopenia (HIT) is a rare complication of heparin treatment resulting in a severe acquired thrombophilic condition with an associated mortality of about 10 %. We report the first case of successful urgent liver transplantation (LT) in a patient with end-stage liver disease due to a Budd–Chiari syndrome, portal vein thrombosis and pulmonary embolism due to acquired thrombophilia associated to polycythemia vera carrying JAK2V617F gene mutation and HIT in the acute phase. Lepirudin was used to provide anticoagulation in the LT perioperative period that was performed without haemorrhagic and thrombotic complications despite the donor received heparin during liver explantation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. De Stefano V, Martinelli I (2010) Splanchnic vein thrombosis: clinical presentation, risk factors and treatment. Intern Emerg Med 5:487–494

    Article  PubMed  Google Scholar 

  2. Tefferi A (2012) Polycythemia vera and essential thrombocythemia: 2012 update on diagnosis, risk stratification, and management. Am J Hematol 87:285–293

    Article  PubMed  Google Scholar 

  3. Dentali F, Squizzato A, Brivio L et al (2009) JAK2V617F mutation for the early diagnosis of myeloproliferative neoplasms in patients with venous thromboembolism: a meta-analysis. Blood 113:5617–5623

    Article  PubMed  CAS  Google Scholar 

  4. Linkins LA, Dans AL, Moores LK et al (2012) Treatment and prevention of heparin-induced thrombocytopenia. antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141:495–530

    Article  Google Scholar 

  5. Warkentin TE, How I (2011) Diagnose and manage HIT. Hematology 1:144–149

    Google Scholar 

  6. Fretschner R, Dietrich K, Unertl K et al (2005) Management of liver transplantation in a patient with a history of heparin-induced thrombocytopenia. Transpl Int 18:664–667

    Article  PubMed  Google Scholar 

  7. Bachmann R, Nadalin S, Li J, Lange J et al (2011) Donor heparinization is not a contraindication to liver transplantation even in recipients with acute heparin-induced thrombocytopenia type II: a case report and review of the literature. Transpl Int 24:89–92

    Article  Google Scholar 

  8. Aloia TA, Goss JA (2009) A report of outcomes after orthotopic liver transplant with allografts from heparin antibody-positive donors. Exp Clin Transplant 7:13–17

    PubMed  Google Scholar 

Download references

Disclosures

All the Authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) the contents of this paper.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marco Marietta.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Biagioni, E., Pedrazzi, P., Marietta, M. et al. Successful liver transplantation in a patient with splanchnic vein thrombosis and pulmonary embolism due to polycythemia vera with Jak2v617f mutation and heparin-induced thrombocytopenia. J Thromb Thrombolysis 36, 352–354 (2013). https://doi.org/10.1007/s11239-012-0832-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11239-012-0832-5

Keywords

Navigation