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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author 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
author_facet 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
author_sort Lorenzo Olivero
collection DOAJ
description 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.
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series Transplantation Reports
spelling doaj-art-aff861885b1d42a2bc9b6416fa9eb0612025-08-20T01:56:45ZengElsevierTransplantation Reports2451-95962024-12-019410016310.1016/j.tpr.2024.100163Combined lung and liver transplant for cirrhosis, idiopathic pulmonary fibrosis, and hemophilia A: Case reportLorenzo Olivero0Hong Liang1Ian A. Makey2Si M. Pham3Jorge Sinclair4Stephen Aniskevich, III5Sadia Z. Shah6Dana K. Perry7Wesley L. Allen8Nathan H. Waldron9Liu Yang10Pramod K. Guru11Candido E. Rivera12Pablo Moreno Franco13Tathagat Narula14Department of Critical Care, Mayo Clinic, Jacksonville, FL, USA; Jacobi Medical Center/Albert Einstein College of Medicine, New York, NY, USADepartment of Anesthesiology, Mayo Clinic, Jacksonville, FL, USADepartment of Cardiovascular and Thoracic Surgery, Mayo Clinic, Jacksonville, FL, USADepartment of Cardiovascular and Thoracic Surgery, Mayo Clinic, Jacksonville, FL, USADepartment of Critical Care, Mayo Clinic, Jacksonville, FL, USA; Mount Sinai Morningside and Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY, USADepartment of Anesthesiology, Mayo Clinic, Jacksonville, FL, USADepartment of Transplant, Mayo Clinic, Jacksonville, FL, USADepartment of Transplant, Mayo Clinic, Jacksonville, FL, USADepartment of Anesthesiology, Mayo Clinic, Jacksonville, FL, USADepartment of Critical Care, Mayo Clinic, Jacksonville, FL, USA; Department of Anesthesiology, Mayo Clinic, Jacksonville, FL, USADepartment of Transplant, Mayo Clinic, Jacksonville, FL, USADepartment of Critical Care, Mayo Clinic, Jacksonville, FL, USA; Department of Transplant, Mayo Clinic, Jacksonville, FL, USADepartment of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USADepartment of Critical Care, Mayo Clinic, Jacksonville, FL, USA; Department of Transplant, Mayo Clinic, Jacksonville, FL, USA; Corresponding author at: Department of Critical Care Medicine, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL 32224, USA.Department of Transplant, Mayo Clinic, Jacksonville, FL, USACombined 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.http://www.sciencedirect.com/science/article/pii/S2451959624000143Liver transplantationLung transplantationHemophilia aCase report
spellingShingle 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
Combined lung and liver transplant for cirrhosis, idiopathic pulmonary fibrosis, and hemophilia A: Case report
Transplantation Reports
Liver transplantation
Lung transplantation
Hemophilia a
Case report
title Combined lung and liver transplant for cirrhosis, idiopathic pulmonary fibrosis, and hemophilia A: Case report
title_full Combined lung and liver transplant for cirrhosis, idiopathic pulmonary fibrosis, and hemophilia A: Case report
title_fullStr Combined lung and liver transplant for cirrhosis, idiopathic pulmonary fibrosis, and hemophilia A: Case report
title_full_unstemmed Combined lung and liver transplant for cirrhosis, idiopathic pulmonary fibrosis, and hemophilia A: Case report
title_short Combined lung and liver transplant for cirrhosis, idiopathic pulmonary fibrosis, and hemophilia A: Case report
title_sort combined lung and liver transplant for cirrhosis idiopathic pulmonary fibrosis and hemophilia a case report
topic Liver transplantation
Lung transplantation
Hemophilia a
Case report
url http://www.sciencedirect.com/science/article/pii/S2451959624000143
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