Thrombophilia in Liver Donors: Prevalence of Protein C or S Deficiency in Korean Candidates and Decision Considerations

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Main Authors: Sola Lee, Suk Kyun Hong, Ja Min Byun, Su young Hong, Jae‐Yoon Kim, Jiyoung Kim, Jeong‐Moo Lee, Youngil Koh, YoungRok Choi, Dong‐Yeop Shin, Nam‐Joon Yi, Kwang‐Woong Lee, Kyung‐Suk Suh
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Published: Wiley 2025
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author Sola Lee
Suk Kyun Hong
Ja Min Byun
Su young Hong
Jae‐Yoon Kim
Jiyoung Kim
Jeong‐Moo Lee
Youngil Koh
YoungRok Choi
Dong‐Yeop Shin
Nam‐Joon Yi
Kwang‐Woong Lee
Kyung‐Suk Suh
author_facet Sola Lee
Suk Kyun Hong
Ja Min Byun
Su young Hong
Jae‐Yoon Kim
Jiyoung Kim
Jeong‐Moo Lee
Youngil Koh
YoungRok Choi
Dong‐Yeop Shin
Nam‐Joon Yi
Kwang‐Woong Lee
Kyung‐Suk Suh
Sola Lee
Suk Kyun Hong
Ja Min Byun
Su young Hong
Jae‐Yoon Kim
Jiyoung Kim
Jeong‐Moo Lee
Youngil Koh
YoungRok Choi
Dong‐Yeop Shin
Nam‐Joon Yi
Kwang‐Woong Lee
Kyung‐Suk Suh
collection Wiley Open Access
contents Thrombophilia in Liver Donors: Prevalence of Protein C or S Deficiency in Korean Candidates and Decision Considerations Sola Lee Suk Kyun Hong Ja Min Byun Su young Hong Jae‐Yoon Kim Jiyoung Kim Jeong‐Moo Lee Youngil Koh YoungRok Choi Dong‐Yeop Shin Nam‐Joon Yi Kwang‐Woong Lee Kyung‐Suk Suh Clinical Transplantation ABSTRACT Background Donor thrombophilia poses risks to both donors and recipients. To address donor safety without unnecessarily decreasing the donor pool, we aimed to determine the incidence of protein C (PC) or protein S (PS) deficiency among living liver donor candidates and propose a decision‐making algorithm for donation. Methods We retrospectively reviewed 1421 living donor candidates who underwent primary donor evaluation at a single center between January 2017 and February 2022. Donors with PC or PS deficiency were divided into severe (< 40%), moderate (40%–49%), and mild (50%–59%) deficiencies and near‐normal (> 60%) groups based on functional activity levels. Demographic and clinical data, including genetic mutation testing, donation status, and postoperative outcomes of both donors and recipients, were analyzed. Results The incidence of PC and PS deficiency after the repeat testing was 0.4% ( n = 6) and 1.7% ( n = 24), respectively. One donor with severe PS deficiency had a PROS1 mutation, and two donors (one from the near‐normal group and one from the mild group) had PROC mutations. None of the 16 donors experienced any thrombotic complications. Three recipients experienced thrombotic complications that were not directly associated with donor thrombophilia. Conclusion The incidences of PC and PS deficiencies among liver donors are significant and should not be overlooked. Each center should consider geographic and ethnic variations when establishing efficient thrombophilia evaluation protocols to ensure donor safety. 10.1111/ctr.70265 http://onlinelibrary.wiley.com/termsAndConditions#vor
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spellingShingle Thrombophilia in Liver Donors: Prevalence of Protein C or S Deficiency in Korean Candidates and Decision Considerations
Sola Lee
Suk Kyun Hong
Ja Min Byun
Su young Hong
Jae‐Yoon Kim
Jiyoung Kim
Jeong‐Moo Lee
Youngil Koh
YoungRok Choi
Dong‐Yeop Shin
Nam‐Joon Yi
Kwang‐Woong Lee
Kyung‐Suk Suh
Clinical Transplantation
Thrombophilia in Liver Donors: Prevalence of Protein C or S Deficiency in Korean Candidates and Decision Considerations Sola Lee Suk Kyun Hong Ja Min Byun Su young Hong Jae‐Yoon Kim Jiyoung Kim Jeong‐Moo Lee Youngil Koh YoungRok Choi Dong‐Yeop Shin Nam‐Joon Yi Kwang‐Woong Lee Kyung‐Suk Suh Clinical Transplantation ABSTRACT Background Donor thrombophilia poses risks to both donors and recipients. To address donor safety without unnecessarily decreasing the donor pool, we aimed to determine the incidence of protein C (PC) or protein S (PS) deficiency among living liver donor candidates and propose a decision‐making algorithm for donation. Methods We retrospectively reviewed 1421 living donor candidates who underwent primary donor evaluation at a single center between January 2017 and February 2022. Donors with PC or PS deficiency were divided into severe (< 40%), moderate (40%–49%), and mild (50%–59%) deficiencies and near‐normal (> 60%) groups based on functional activity levels. Demographic and clinical data, including genetic mutation testing, donation status, and postoperative outcomes of both donors and recipients, were analyzed. Results The incidence of PC and PS deficiency after the repeat testing was 0.4% ( n = 6) and 1.7% ( n = 24), respectively. One donor with severe PS deficiency had a PROS1 mutation, and two donors (one from the near‐normal group and one from the mild group) had PROC mutations. None of the 16 donors experienced any thrombotic complications. Three recipients experienced thrombotic complications that were not directly associated with donor thrombophilia. Conclusion The incidences of PC and PS deficiencies among liver donors are significant and should not be overlooked. Each center should consider geographic and ethnic variations when establishing efficient thrombophilia evaluation protocols to ensure donor safety. 10.1111/ctr.70265 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Thrombophilia in Liver Donors: Prevalence of Protein C or S Deficiency in Korean Candidates and Decision Considerations
topic Clinical Transplantation
url https://onlinelibrary.wiley.com/doi/10.1111/ctr.70265