English 
Italian CASI CLINICI – Case Reports
Volume:
Biochimica Clinica 2018; 42(3) e37-e39
Pubblicato on-line:
May 25, 2018
DOI:
10.19186/BC_2018.032
Ruolo del laboratorio nella valutazione di un donatore di organi con sospetta emofilia A
AUTORI
1UOC Laboratorio Patologia Clinica, Azienda Ospedaliera Universitaria Senese, Policlinico Santa Maria alle Scotte, Siena
2Dipartimento di Biotecnologie Mediche, Università di Siena
3Dipartimento di Medicina Interna, Policlinico di Monza
ABSTRACT
Role of the laboratory in the evaluation of an organ donor with reported haemophilia A
The case concerns a 82-year-old patient, organ donor, affected by diabetes mellitus, hypertension and reported type A haemophilia, showing a traumatic severe cerebral haemorrhage. The Medical Committee started the donor evaluation process: the liver was compatible for a recipient in life-threatening conditions. Although the first level coagulation tests were within the normal range, the Regional Center for Organ and Tissue Allocation of the Tuscany Region – Italy requested further investigations in order to clarify the reported diagnosis of haemophilia and to exclude the presence of a specific FVIII inhibitor. FVII activity was evaluated to assess the protein synthesis of the liver, and FVIII for suspected haemophilia; both of them were normal. Considering the importance of the diagnosis, the parallelisms of both FVII and FVIII were performed; the tests were negative for the presence of inhibitors. Second-level tests therefore rejected the diagnosis of haemophilia and excluded the presence of a specific inhibitor of FVIII. The absence of coagulative alterations allowed the liver explant, which was successfully transplanted on a 59-year-old male recipient.