32nd Hemophilia Symposium Hamburg 2001 (2003)

Seven months following LTX quality of live has increased markedly in the hereby presented patient. A prolonged life expectance can be anticipated due to improved liver function and decreased bleedingtendency as a result of elevated leukocyte and thrombocyte counts. A positive surprise is the patients comment of less joint pain in spite of unchanged hemophilic arthropathy. If this is also true for other haemo- philia patients following LTX this may develop as a new objective towards gene therapy as well. From a clinical perspective bleeding risk ismarkedlyreduced due to nearlynor- mal factor VIII and thrombocyte levels as well as a presumable reduction of blood pressure in esophageal varacies. CD4-Helper cells increased significantly after LTX. However, at the same time a decrease of CD4/CD8 ratio was measured. CD4 count alone may therefore not be appropriate for HIV staging or subsequent decision whether or not immunfunction is sufficient for later LTX. Due to a CD4 count of above 700following livertransplantations the risk of opportunistic infections islow at this time. According to these preliminary results LTX should be considered in a subgroup of haemophilia patients with advanced liver cirrhosis in spite of HIV infection. Dysfibrinogenemia following after Snake Bite M. KRAUSE, J. BOJUNGA, D. MEBS, and I. SCHARRER Introduction A 35 year old snake breeder was bitten on the left foot by a middle American pit viper Crotalus durissus dryinas which had escaped.