The Liver That Cured Christmas: Case Report of Orthotopic Liver Transplant in a Patient with Hemophilia B

Author:

Harris Jesse E.1ORCID,Balk Jonathan L.1,Mobley Constance M.2,Heyne Kirk3

Affiliation:

1. Department of Pharmacy, Houston Methodist Hospital, USA

2. Department of Transplant Surgery, Houston Methodist Hospital, USA

3. Department of Oncology, Houston Methodist Hospital, USA

Abstract

Herein, we discuss a case of a 39-year-old male with hemophilia B, who developed end-stage liver disease secondary to nonalcoholic steatohepatitis, that underwent orthotopic liver transplantation (OLT) as a curative means for his liver disease and coagulation disorder. Existing case reports have demonstrated favorable outcomes in patients outside of the United States who received continuous infusions of recombinant factor IX replacement in the perioperative setting after liver transplant. Given limitations in the stability of the recombinant factor IX products in the United States, a dosing strategy was comprised of once daily bolus dosing to achieve satisfactory factor IX levels. Within 48 hours of initial surgery, the patient had sustained factor IX levels above 70% of normal and the patient required no further dosing of factor IX products to date. This strategy helped facilitate less frequent dosing as well as achieved targeted factor levels while synthetic function of the transplanted liver recovered.

Funder

Houston Methodist Hospital

Publisher

Hindawi Limited

Subject

General Earth and Planetary Sciences,General Engineering,General Environmental Science

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