Factor XI deficiency acquired by liver transplantation

K. Clarkson, B. Rosenfeld, J. Fair, A. Klein, W. Bell

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Factor XI deficiency (the Rosenthal syndrome), an autosomal recessive genetic defect, was transmitted to a patient after orthotopic liver transplantation. The deficiency was manifested by an isolated prolonged activated partial thromboplastin time (aPTT) after surgery. Hematologic evaluation using specific factor analysis revealed an absolute deficiency of factor XI. Stored serum obtained from the organ recipient before transplantation showed normal factor XI levels. When the liver donor's family was questioned, it was discovered that he was of Ashkenazi Jewish descent and that he had a history of bleeding after dental procedures. Before his death from intracerebral bleeding, he was documented to have an isolated prolonged aPTT value. This case shows that potentially morbid genetic defects can be transmitted by organ transplantation. It also provides evidence confirming that the liver is the only site of factor XI production.

Original languageEnglish (US)
Pages (from-to)877-879
Number of pages3
JournalAnnals of internal medicine
Issue number11
StatePublished - Jan 1 1991
Externally publishedYes


  • Blood coagulation disorders
  • Factor XI deficiency
  • Hereditary diseases
  • Liver transplantation
  • Partial thromboplastin time

ASJC Scopus subject areas

  • Internal Medicine


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