Factor XI deficiency acquired by liver transplantation

TitleFactor XI deficiency acquired by liver transplantation
Publication TypeJournal Article
Year of Publication1991
AuthorsClarkson K, Rosenfeld B, Fair J, Klein A, Bell W
JournalAnn Intern Med
Pagination877 - 9
Date PublishedDec 1
ISSN0003-4819 (Print) 0003-4819 (Linking)
Accession Number1952475
KeywordsFactor XI Deficiency / *etiology, Humans, Liver Transplantation / *adverse effects, Male, Middle Aged, Partial Thromboplastin Time, Tissue Donors

Factor XI deficiency (the Rosenthal syndrome), an autosomal recessive genetic defect, was transmitted to a patient after orthotopic liver transplantation. The deficiency was manifested by an isolated prolonged activated partial thromboplastin time (aPTT) after surgery. Hematologic evaluation using specific factor analysis revealed an absolute deficiency of factor XI. Stored serum obtained from the organ recipient before transplantation showed normal factor XI levels. When the liver donor's family was questioned, it was discovered that he was of Ashkenazi Jewish descent and that he had a history of bleeding after dental procedures. Before his death from intracerebral bleeding, he was documented to have an isolated prolonged aPTT value. This case shows that potentially morbid genetic defects can be transmitted by organ transplantation. It also provides evidence confirming that the liver is the only site of factor XI production.

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