The impact of inherited thrombophilia on surgery: a factor to consider before transplantation?

This article mainly reviews hypercoagulability--and specifically inherited thrombophilia--in different types of surgery including kidney transplantation, simultaneous kidney and pancreas transplantation, orthopedic surgery, vascular surgery, cardiac surgery and other categories of surgical procedures, with a major focus on its associated complications and the need to screen or not. A search was conducted using Medline and cross-referencing for articles related to thrombophilia, screening for it, and its association with surgical complications post-op. Thrombosis associated predisposing entities like factor V Leiden, Prothrombin and Methylene tetrahydrofolate reductase gene mutations, in addition to Protein C and S deficiencies, are discussed. In addition, common and relatively uncommon complications of thrombophilia in the above mentioned surgeries will be covered in length, as well as the necessity to screen for thrombophilia prior to the surgical step. This topic is gaining more and more importance for both surgeons and internists (especially Hematologists) and we, herein, present a general review of the published literature as an update on the subject.