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Sageshima J, Chandar J, Chen LJ, Shah R, Al Nuss A, Vincenzi P, Morsi M, Figueiro J, Vianna R, Ciancio G, Burke GW. How to Deal With Kidney Retransplantation-Second, Third, Fourth, and Beyond. Transplantation 2022; 106:709-721. [PMID: 34310100 DOI: 10.1097/tp.0000000000003888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Kidney transplantation is the best health option for patients with end-stage kidney disease. Ideally, a kidney transplant would last for the lifetime of each recipient. However, depending on the age of the recipient and details of the kidney transplant, there may be a need for a second, third, fourth, or even more kidney transplants. In this overview, the outcome of multiple kidney transplants for an individual is presented. Key issues include surgical approach and immunologic concerns. Included in the surgical approach is an analysis of transplant nephrectomy, with indications, timing, and immunologic impact. Allograft thrombosis, whether related to donor or recipient factors merits investigation to prevent it from happening again. Other posttransplant events such as rejection, viral illness (polyomavirus hominis type I), recurrent disease (focal segmental glomerulosclerosis), and posttransplant lymphoproliferative disease may lead to the need for retransplantation. The pediatric recipient is especially likely to need a subsequent kidney transplant. Finally, noncompliance/nonadherence can affect both adults and children. Innovative approaches may reduce the need for retransplantation in the future.
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Affiliation(s)
- Junichiro Sageshima
- Division of Transplant Surgery, Department of Surgery, University of California Davis School of Medicine, Sacramento, CA
| | - Jayanthi Chandar
- Division of Pediatric Kidney Transplantation, Department of Pediatrics, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Linda J Chen
- Division of Kidney-Pancreas Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Rushi Shah
- Surgical Transplant Fellow, Division of Kidney-Pancreas Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Ammar Al Nuss
- Surgical Transplant Fellow, Division of Kidney-Pancreas Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Paolo Vincenzi
- Surgical Transplant Fellow, Division of Kidney-Pancreas Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Mahmoud Morsi
- Division of Kidney-Pancreas Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Jose Figueiro
- Division of Kidney-Pancreas Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Rodrigo Vianna
- Division of Kidney-Pancreas Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
- Division of Liver and GI Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Gaetano Ciancio
- Division of Kidney-Pancreas Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
| | - George W Burke
- Division of Kidney-Pancreas Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL
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Assaf N, Chamseddine F, Taher A, Mahfouz R. Prevalence of thrombophilia-associated mutations and their clinical significance in a large cohort of Lebanese patients. Meta Gene 2021. [DOI: 10.1016/j.mgene.2021.100936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Huynh MNQ, Bhagirath V, Gupta M, Avram R, Cheung K. Multidisciplinary Practice Variations of Anti-Thrombotic Strategies for Free Tissue Transfers. Plast Surg (Oakv) 2021; 30:343-352. [PMID: 36212097 PMCID: PMC9537717 DOI: 10.1177/22925503211024742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/25/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Venous thrombosis, the leading cause of free flap
failure, may have devastating consequences. Many anti-thrombotic agents and
protocols have been described for prophylaxis and treatment of venous thrombosis
in free flaps. Methods: National surveys were distributed to
microsurgeons (of both Plastics and ENT training) and hematology and thrombosis
specialists. Data were collected on routine screening practices, perceived risk
factors for flap failure, and pre-, intra-, and post-operative anti-thrombotic
strategies. Results: There were 722 surveys distributed with 132
(18%) respondents, consisting of 102 surgeons and 30 hematologists. Sixty-five
surgeons and 9 hematologists routinely performed or managed patients with free
flaps. The top 3 perceived risk factors for flap failure according to surgeons
were medical co-morbidities, past arterial thrombosis, and thrombophilia.
Hematologists, however, reported diabetes, smoking, and medical co-morbidities
as the most important risk factors. Fifty-four percent of physicians routinely
used unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) as a
preoperative agent. Surgeons routinely flushed the flap with heparin (37%), used
UFH IV (6%), or both (8%) intra-operatively. Surgeons used a range of
post-operative agents such as UFH, LMWH, aspirin, and dextran while
hematologists preferred LMWH. There was variation of management strategies if
flap thrombosis occurred. Different strategies consisted of changing recipient
vessels, UFH IV, flushing the flap, adding post-operative agents, or a
combination of strategies. Conclusions: There are diverse practice
variations in anti-thrombotic strategies for free tissue transfers and a
difference in perceived risk factors for flap failure that may affect patient
management.
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Affiliation(s)
- Minh N. Q. Huynh
- Division of Plastic Surgery, McMaster University, Hamilton, Ontario,
Canada
- Minh N. Q. Huynh, BSc, Division of Plastic
Surgery, McMaster University, 1280 Main St, Hamilton, Ontario, Canada L8S 4L8.
| | - Vinai Bhagirath
- Division of Hematology, McMaster University, Hamilton, Ontario,
Canada
| | - Michael Gupta
- Division of Otolaryngology, McMaster University, Hamilton, Ontario,
Canada
| | - Ronen Avram
- Division of Plastic Surgery, McMaster University, Hamilton, Ontario,
Canada
| | - Kevin Cheung
- Division of Plastic and Reconstructive Surgery, Children’s Hospital
of Eastern Ontario, Ottawa, Ontario, Canada
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Vandeput AS, Brijs K, De Kock L, Janssens E, Peeters H, Verhamme P, Politis C. Maxillofacial and oral surgery in patients with thrombophilia: safe territory for the oral surgeon? A single-center retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:514-522. [PMID: 34030997 DOI: 10.1016/j.oooo.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/25/2021] [Accepted: 03/02/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to analyze patients with thrombophilia who underwent oral and/or maxillofacial surgery at our center. STUDY DESIGN We performed a retrospective analysis of patients with hereditary or acquired thrombophilia who had undergone oral/maxillofacial surgery between January 1, 2000 and December 31, 2019. Data regarding demographic and patient characteristics, surgical treatment modalities, antithrombotic therapies, and complications were analyzed. RESULTS A total of 76 eligible patients (26 male, 50 female) were included in this study, with a mean follow-up period of 3.8 months (range, 0-51 months). The mean age at time of surgery was 44.7 ± 19.4 years. Seven different hereditary and acquired thrombophilia were identified: factor V Leiden (n = 31; 40.8%), prothrombin G20210A mutation (n = 5; 6.6%), protein C deficiency (n = 4; 5.3%), protein S deficiency (n = 11; 14.5%), antiphospholipid syndrome (n = 10; 13.2%), hyperhomocysteinemia (n = 8; 10.5%), and elevated factor VIII (n = 2; 2.6%). Complications occurred in 9 patients (11.8%) and included postoperative infections (n = 6; 7.9%) and postoperative bleeding (n = 3; 3.9%). CONCLUSION Our data suggest that oral and/or maxillofacial surgery in patients with a confirmed diagnosis of thrombophilia is not associated with a burden of thrombosis or high complication rates. Furthermore, we formulated a guideline for preoperative antithrombotic therapy for patients with thrombophilia undergoing oral and/or maxillofacial surgery.
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Affiliation(s)
- An-Sofie Vandeput
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - Katrien Brijs
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Lisa De Kock
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Elien Janssens
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Hilde Peeters
- Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Peter Verhamme
- Department of Vascular Medicine and Haemostasis, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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Buder K, Zirngibl M, Bapistella S, Nadalin S, Tönshoff B, Weitz M. Current practice of antithrombotic prophylaxis in pediatric kidney transplantation-Results of an international survey on behalf of the European Society for Paediatric Nephrology. Pediatr Transplant 2020; 24:e13799. [PMID: 33119218 DOI: 10.1111/petr.13799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/05/2020] [Accepted: 06/28/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Renal graft thrombosis (RGT) is one of the main causes for early graft loss in pediatric kidney transplantation (KTx). Despite the lack of evidence-based recommendations, antithrombotic prophylaxis (aP) is used to prevent RGT. METHODS An online survey supported by the European Society for Pediatric Nephrology was developed to investigate the current practice of aP in pediatric KTx recipients <18 years. RESULTS A total of 80 pediatric KTx centers from 37 countries participated in the survey. Antithrombotic prophylaxis was performed in 96% of the pediatric renal transplant centers (all/selected patients: 54%/42%). The main overall used drugs were as follows: low-molecular-weight heparin (89%), unfractionated heparin (UFH) (69%), and acetylsalicylic acid (ASS) (55%). Ten different aP management strategies were identified as follows: 51% used a single drug and 48% combined two drugs sequentially. The corresponding centers started aP predominantly within 24 hours after pediatric KTx; 51% preferred UFH for starting aP. In centers switching to a second drug (51%), this change was performed after 10 ± 6 days; of these 57% preferred ASS for maintenance aP. Reported median aP duration was 51 days (range 1-360). CONCLUSIONS Despite the use of aP in almost all responding pediatric KTx centers, there is no uniform management strategy. Notwithstanding, UFH seems to be the preferred drug for the early post-operative period of pediatric KTx, and ASS for maintenance prophylaxis following pediatric KTx. Prospective studies are needed to further evaluate the benefits and risks of aP, preferably resulting in guidelines for the management in pediatric KTx.
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Affiliation(s)
- Kathrin Buder
- Pediatric Nephrology Department, University Children`s Hospital Zurich, Zurich, Switzerland
| | - Matthias Zirngibl
- Department of General Pediatrics and Hematology/Oncology, University Hospital Tübingen, University Children`s Hospital, Tübingen, Germany
| | - Sascha Bapistella
- Department of General Pediatrics and Hematology/Oncology, University Hospital Tübingen, University Children`s Hospital, Tübingen, Germany
| | - Silvio Nadalin
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Marcus Weitz
- Department of General Pediatrics and Hematology/Oncology, University Hospital Tübingen, University Children`s Hospital, Tübingen, Germany
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Hautala G, Liu B, Hamilton D, Aneja A, Moghadamian E. Below-Knee Amputation Resulting from an Arterial Thrombosis from Tourniquet Use in a Patient with Undiagnosed Factor V Leiden: A Case Report. JBJS Case Connect 2020; 10:e0457. [PMID: 32224658 DOI: 10.2106/jbjs.cc.19.00457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
CASE A 38-year-old woman presented with previously undiagnosed factor V Leiden (FVL), who suffered a complete superficial femoral arterial thrombosis after tourniquet use during the surgical repair of one of her bilateral tibial plafond fractures. This patient's injury eventually resulted in a below-knee amputation. CONCLUSION We recommend expanding hypercoagulable screening on patients with risk factors based on a detailed history and physical examination. We also recommend limiting or negating tourniquet use in patients with FVL or other hypercoagulable disorders.
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Affiliation(s)
- Gavin Hautala
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky
| | - Boshen Liu
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky
| | - David Hamilton
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky
| | - Arun Aneja
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky
| | - Eric Moghadamian
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky
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Bauer KA, Nguyen-Cao TM, Spears JB. Issues in the Diagnosis and Management of Hereditary Antithrombin Deficiency. Ann Pharmacother 2016; 50:758-67. [DOI: 10.1177/1060028016651276] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: To review insights gained in the past several years about hereditary antithrombin (AT) deficiency and to outline approaches to the management of patients with AT deficiency in the acute and chronic settings. Data Sources: An extensive literature search of Scopus (January 2008-April 2016) was performed for the terms congenital antithrombin deficiency, inherited antithrombin deficiency, or hereditary antithrombin deficiency. Additional references were identified by reviewing literature citations. Study Selection: All relevant English-language case reports, reviews, clinical studies, meeting abstracts, and book chapters assessing hereditary AT deficiency were included. Data Synthesis: AT deficiency significantly increases the risk of venous thromboembolism (VTE). The risk of VTE is particularly high during pregnancy, the postpartum period, and following major surgery. Effective clinical management includes determination of the appropriate type and duration of antithrombotic therapy (ie, AT replacement for acute situations) while minimizing the risk of bleeding. For persons newly diagnosed with AT deficiency, age, lifestyle, concurrent medical conditions, family history, and personal treatment preferences can be used to individualize patient management. Patients should be informed of the risks associated with hormonal therapy, pregnancy, surgical procedures, and immobility, which further increase the risk of VTE in patients with AT deficiency. Conclusion: AT deficiency poses the highest risk for VTE among the hereditary thrombophilias, often requiring long-term anticoagulation. Undertaking an evaluation for hereditary thrombophilia is controversial; however, a diagnosis of VTE in association with AT deficiency can have management implications. An important treatment option for patients with this disorder in high-risk situations is AT concentrate.
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8
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González-Moreno J, Callejas-Rubio JL, Ríos-Fernández R, Ortego-Centeno N. Antiphospholipid syndrome, antiphospholipid antibodies and solid organ transplantation. Lupus 2015; 24:1356-63. [DOI: 10.1177/0961203315595129] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 06/17/2015] [Indexed: 11/16/2022]
Abstract
Antiphospholipid syndrome is considered a high risk factor for any kind of surgery. Considering that all solid organ transplants are critically dependent on the patency of vascular anastomosis, there is much concern about the consequences this pro-thrombotic condition may have on transplantation. Relatively little information is available in the literature assessing the real risk that antiphospholipid syndrome or the presence of antiphospholipid antibodies represent in solid organ transplantation. The aim of this article is to review the literature related to transplantation of solid organs in patients diagnosed with antiphospholipid syndrome or patients with positive antiphospholipid antibodies.
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Affiliation(s)
- J González-Moreno
- Internal Medicine Department, Hospital Son Llàtzer, Palma de Mallorca, Illes Balears, Spain
| | - J L Callejas-Rubio
- Autoimmune Diseases Unit, Internal Medicine Department, Hospital Clínico San Cecilio, Granada, Spain
| | - R Ríos-Fernández
- Autoimmune Diseases Unit, Internal Medicine Department, Hospital Clínico San Cecilio, Granada, Spain
| | - N Ortego-Centeno
- Autoimmune Diseases Unit, Internal Medicine Department, Hospital Clínico San Cecilio, Granada, Spain
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Hoteit R, Taher A, Nassar R, Otrock Z, Halawi R, Mahfouz RA. Frequency of Triple Mutations Involving Factor V, Prothrombin, and Methylenetetrahydrofolate Reductase Genes Among Patients Referred for Molecular Thrombophilia Workup in a Tertiary Care Center in Lebanon. Genet Test Mol Biomarkers 2012; 16:223-5. [DOI: 10.1089/gtmb.2011.0114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Rouba Hoteit
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Ali Taher
- Department of Internal Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Rabih Nassar
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Zaher Otrock
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Racha Halawi
- Department of Internal Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Rami A.R. Mahfouz
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
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Hoteit R, Halas H, Hassanieh S, Mahfouz RAR. Laboratory referral rates of genetic tests for thrombophilia workup in a major referral center. Genet Test Mol Biomarkers 2011; 16:459-62. [PMID: 22191678 DOI: 10.1089/gtmb.2011.0220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS The rate of laboratory referrals for thrombophilia patients' genetic workup was assessed and compared among the medical and surgical specialties and subspecialties at a major tertiary care center in Lebanon. METHODS DNA extraction was performed using the PEL-FREEZ extraction kit (PEL-FREEZ; DYNAL) and the Factor V, prothrombin, and methylenetetrahydrofolate reductase genotypic profiles were done using the FV-PTH-MTHFR StripAssay kit (ViennaLab) that employs a polymerase chain reaction-reverse hybridization method. A total of 2238 referred cases were analyzed. RESULTS Around 42.23% of all referred cases turned out to have a thrombosis-associated mutation. Referrals from medical and surgical specialties were almost equal. In the surgical specialty, most referrals came from the department of Obstetrics and Gynecology, while in the medical speciality, most of the workup referrals originated from the Hematology/Oncology physicians. However, low referral rates were reported from the emergency department and family medicine practitioners. CONCLUSION Genetic testing for thrombophilia workup is gaining more importance among the different medical and surgical specialties and is worth being introduced into the offered test lists of all established molecular diagnostics laboratories.
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Affiliation(s)
- Rouba Hoteit
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Toronyi E, Máthé Z, Chmel R, Varga M, Kozma V, Trent R, Tozsér G, Nagy G, Langer R. [Incidence of thrombophilia and risk of renal vessel thrombosis in kidney transplant recipients]. Magy Seb 2011; 64:229-34. [PMID: 21997526 DOI: 10.1556/maseb.64.2011.5.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Kidney transplantation is the optimal treatment of end stage kidney disease. The most common vascular complication in the early postoperative period is thrombosis of the renal artery and vein. These complications usually lead to the loss of the transplanted kidney. AIM of our study was to identify those factors which represent an increased risk for thrombotic complication and determine whether routine screening for thrombophilia is justifiable before transplantation. As an illustration to this problem we report a case of successful renal vein recanalisation after thrombosis. METHODS We give an overview of the literature about incidence of renal graft thrombosis, hypercoagulable states, predictive value of factor V. Leiden and prothrombin G20210A mutations in venous thromboembolism. We discuss those publications that suggest a preoperative screening of transplant candidates for hypercoagulable states and thrombophilia and those that do not think that such screening is reasonable. In our case a 28 year old male patient received a cadaveric kidney. Thrombosis of the renal vein was diagnosed 8 hours after transplantation. Reoperation was performed immediately: venous anastomosis was opened, the thrombus removed. After reoperation the circulation of the kidney recovered, intravenous heparin treatment was introduced immediately. RESULTS 24 months later the kidney is still functioning well. Postoperative thrombophilia screening showed heterozygosity for factor V Leiden. CONCLUSION There are only few publications reporting on successful recanalisation after renal vein thrombosis. In our case rapid diagnosis and immediate operative treatment saved the graft. There is no uniform proposal in the literature whether preoperative screening for thrombophilia is justifiable or not. In our view screening for thrombophilia and thromboprophylaxis is mandatory. Extensive prospective studies should be undertaken to refine the risks and establish the associations of thrombophilia and thromboembolism after kidney transplantation.
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Affiliation(s)
- Eva Toronyi
- Semmelweis Egyetem Transzplantációs és Sebészeti Klinika 1082 Budapest Baross u. 23-25.
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Rahimi Z, Felehgari V, Rahimi M, Mozafari H, Yari K, Vaisi-Raygani A, Rezaei M, Malek-Khosravi S, Khazaie H. The frequency of factor V Leiden mutation, ACE gene polymorphism, serum ACE activity and response to ACE inhibitor and angiotensin II receptor antagonist drugs in Iranians type II diabetic patients with microalbuminuria. Mol Biol Rep 2010; 38:2117-23. [DOI: 10.1007/s11033-010-0338-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Accepted: 09/04/2010] [Indexed: 11/28/2022]
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Hereditary Coagulopathies: Practical Diagnosis and Management for the Plastic Surgeon. Plast Reconstr Surg 2010; 125:1544-1552. [DOI: 10.1097/prs.0b013e3181d51344] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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