Lekehal B, Ait Youssef N, Lekehal M, Jdar A, El Hassani AEA, Belyazid I, Bakkali T, Bounssir A. Acute graft thrombosis in a patient with factor V Leiden mutation: A case report and review of literature. World J Transplant 2026; 16(1): 114162 [DOI: 10.5500/wjt.v16.i1.114162]
Corresponding Author of This Article
Noura Ait Youssef, MD, Department of Vascular Surgery, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University in Rabat, Avenue Bettouga, Rabat 6527, Rabat-Salé-Kénitra, Morocco. nouraaityoussef94@gmail.com
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Transplantation
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 18, 2026 (publication date) through Jan 14, 2026
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World Journal of Transplantation
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2220-3230
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Lekehal B, Ait Youssef N, Lekehal M, Jdar A, El Hassani AEA, Belyazid I, Bakkali T, Bounssir A. Acute graft thrombosis in a patient with factor V Leiden mutation: A case report and review of literature. World J Transplant 2026; 16(1): 114162 [DOI: 10.5500/wjt.v16.i1.114162]
World J Transplant. Mar 18, 2026; 16(1): 114162 Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.114162
Acute graft thrombosis in a patient with factor V Leiden mutation: A case report and review of literature
Brahim Lekehal, Noura Ait Youssef, Mehdi Lekehal, Asma Jdar, Amine El Azami El Hassani, Ismail Belyazid, Tarik Bakkali, Ayoub Bounssir
Brahim Lekehal, Noura Ait Youssef, Asma Jdar, Amine El Azami El Hassani, Tarik Bakkali, Ayoub Bounssir, Department of Vascular Surgery, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University Rabat, Rabat 6527, Rabat-Salé-Kénitra, Morocco
Mehdi Lekehal, Department of Vascular Surgery, Centre Hospitalier Universitaire Ibn Sina, Rabat 6527, Rabat-Salé-Kénitra, Morocco
Ismail Belyazid, Department of Nephrology, Dialysis and Transplantation, Cheikh Zaid University Hospital, Rabat 6533, Rabat-Salé-Kénitra, Morocco
Author contributions: Lekehal B carried out the experiments and led the project administration; Ait Youssef N and Lekehal M wrote the first draft of the manuscript and collected the data; Bounssir A, Bakkali T, Jdar A, El Azami El Hassani A, and Belyazid I contributed to the data interpretation and visualization; All authors reviewed, edited, and approved the final version of the manuscript.
Informed consent statement: Complete written informed consent was obtained from the patient (the donor and the recipient) for the publication of this study and accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Noura Ait Youssef, MD, Department of Vascular Surgery, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University in Rabat, Avenue Bettouga, Rabat 6527, Rabat-Salé-Kénitra, Morocco. nouraaityoussef94@gmail.com
Received: September 16, 2025 Revised: October 28, 2025 Accepted: December 18, 2025 Published online: March 18, 2026 Processing time: 121 Days and 21.6 Hours
Abstract
BACKGROUND
Early renal artery thrombosis after kidney transplantation is rare but often leads to graft loss. Prompt diagnosis and intervention are essential, particularly in patients with inherited thrombophilias such as factor V Leiden (FVL) mutation.
CASE SUMMARY
A kidney transplant recipient with FVL mutation developed an acute transplant renal artery thrombosis. The immediate post-operative Doppler ultrasonography revealed thrombosis of the main and inferior polar renal arteries. Emergent thrombectomy and separate arterial re-anastomoses were performed after cold perfusion with heparinized saline and vasodilator solution. Reperfusion was successful with immediate urine output and gradual improvement in renal function. The patient was discharged on direct oral anticoagulation therapy.
CONCLUSION
Early detection and surgical intervention can preserve graft function in post-transplant renal artery thrombosis even in patients at high risk.
Core Tip: Vascular thrombosis is an uncommon but serious complication in renal transplantation. Vigilant postoperative monitoring is essential for early detection. We described the successful salvage of a renal allograft with arterial thrombosis in a patient with factor V Leiden mutation, using a technically challenging donor kidney with dual arteries.
