Bleeding complications are common in recipients of hemophilia orthotopic liver transplantation, according to a study involving more than 11,000 individuals. For this reason, it may make sense to aggressively correct coagulation defects in these patients.

Investigators assessed epidemiology and outcomes in hemophilia liver transplant recipients between 1993 and 2012. Among the results:

• 44 patients had hemophilia.
• 45% of those with hemophilia experienced bleeding complications, vs 32% of those without hemophilia.
• 7% of those with hemophilia experienced hypovolemic shock, vs 1% of those without hemophilia.
• Patients with hemophilia also had significantly higher incidence of HIV (25% vs 0.5%), hepatitis B (16% vs 8%), and vitamin K deficiency (2% vs 0.02%).
• There was no difference in in-hospital mortality between the 2 groups.
• Bleeding complications in hemophilia increased the risk of in-hospital mortality by more than 3-fold.
• Disseminated intravascular coagulation increased the risk of bleeding complications in hemophilic recipients by more than 10-fold.