Coagulation Factor Deficiency Following Liver Transplantation

Features:

(1) no evidence of a coagulation factor deficiency prior to the liver transplant

(2) presence of the deficiency after the liver transplantation

This has been reported for:

(1) Factor VIII

(2) Factor XI

(3) Factor VII

(4) Factor XII

There are 2 possible mechanisms:

(1) the liver donor had an unrecognized coagulation factor deficiency with deficient production by the liver

(2) production an anti-factor antibody, possibly by lymphocytes in the transplanted liver

Differential diagnosis:

(1) consumptive coagulopathy related to rejection or infection

(2) unrecognized factor deficiency in the recipient unmasked by the transplant