Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Von Willebrand disease (VWD) is a haematological condition that can be challenging to deal with during any operative intervention. We report a successful example of live kidney donation from a donor with VWD with no perioperative complications.
*Methods: A 43 year old female patient wanted to donate a kidney to her relative with end stage renal disease. The donor is fit and well but during the course of routine investigations we found abnormal levels of activated partial thromboplastin time (APTT) of 0.37 iu/ml (normal range 0.48- 1.73) and factor VIII level of 0.58 iu/ml (normal range 0.62- 1.99). She was reviewed by the haematologist who recommended treatment to increase Von Willebrand factor activity to > 0.5 iu/ml either with D-amino D-arginine vasopressin (DDAVP) or coagulation factor concentrates (CFC). Following a multidisciplinary team (MDT) discussion, CFC was deemed the best option in her case.
*Results: Thorough discussion was made with the donor with regards to the small risk of transmission of blood borne viruses (BBV) despite the course of immunisation that she was offered earlier. The donor received Voncento (Von Willebrand factor + factor VIII) and had an uneventful hand- assisted laparoscopic left donor nephrectomy. She was discharged home on day 3 then followed up in the clinic with no complications to report. She continues to be seen in a routine yearly follow up as per our unit protocol. The recipient had excellent graft function.
*Conclusions: Donors with VWD should be considered for live kidney donation following peril-operative correction of Von Willebrand factor and after discussion in an MDT approach. The donors should be involved in the decision making process as to which route of treatment to choose from including the risk of transmission of BBV.
To cite this abstract in AMA style:Marie Y, McKane W, Maclean R, Pararajasingam R. Can a Patient with Von Willebrand Disease Donate a Kidney? [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/can-a-patient-with-von-willebrand-disease-donate-a-kidney/. Accessed December 5, 2020.
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