Combined lung and liver transplant for cirrhosis, idiopathic pulmonary fibrosis, and hemophilia A: Case report

Combined lung and liver transplantation (CLLT) is a rare intervention for end-stage lung and liver diseases. It poses a challenge for patients with increased bleeding risk due to Hemophilia A and liver coagulopathy. We present the first documented case of CLLT in an elderly male with Hemophilia A, H...

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Main Authors: Lorenzo Olivero, Hong Liang, Ian A. Makey, Si M. Pham, Jorge Sinclair, Stephen Aniskevich, III, Sadia Z. Shah, Dana K. Perry, Wesley L. Allen, Nathan H. Waldron, Liu Yang, Pramod K. Guru, Candido E. Rivera, Pablo Moreno Franco, Tathagat Narula
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Transplantation Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2451959624000143
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Summary:Combined lung and liver transplantation (CLLT) is a rare intervention for end-stage lung and liver diseases. It poses a challenge for patients with increased bleeding risk due to Hemophilia A and liver coagulopathy. We present the first documented case of CLLT in an elderly male with Hemophilia A, HCV-associated cirrhosis, and Idiopathic Pulmonary Fibrosis (IPF). Despite the patient exhibiting stable liver function and hemophilia, his lung condition rapidly deteriorated, prompting the listing for transplant. The patient underwent a successful CLLT with perioperative management coordinated by the multidisciplinary team to address the unique challenges of Hemophilia A, resulting in intra-operative correction of coagulopathy. The patient exhibited a favorable recovery, with no requirement for Factor FVIII replacement therapy postoperatively. This case demonstrates that CLLT can address three diseases with distinct pathophysiologies: end-stage lung and liver disease, and correct the hemophilia A phenotype. Our report contributes to the limited literature on the suitability of CLLT in patients with hemophilia A.
ISSN:2451-9596