Ask the Experts - Renal Transplantation in a Hemophiliac?
Do you have experience with successful management of renal transplantation in a hemophilic recipient?

Niang Abdou, MD

We have never been faced with this situation; it must be quite rare. I tend to think of hemophilia as a disease that would be "cured" by liver transplantation, so that combined or staged liver/kidney transplantation would be an option. Otherwise, I suppose that support with perioperative cryoprecipitate or Factor VIII (or whatever my hematologist would recommend) would work, and similarly around the time of any biopsy. I would emphasize, however, that we have no experience with the combination of hemophilia and renal failure, and I would be surprised if there were many programs, if any, that have seen this.

Editor's Note: A MEDLINE literature search for the last 5 years identified only 1 citation, which is an editorial. The citation is as follows:

Roy-Chaudhury P, Manfro RC. Renal replacement therapy for hemophiliacs. Int J Artif Organs. 1997;20:241-243.