Identifying and managing inhibitor patients requiring orthopaedic surgery - the multidisciplinary team approach

Until recently, surgery in haemophilia patients with inhibitors was strongly contraindicated and was therefore often not even contemplated. Inhibitor patients entering the surgical arena face unique challenges; the most frequently encountered problem during surgical intervention is bleeding, and thr...

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Bibliographic Details
Published in:Haemophilia : the official journal of the World Federation of Hemophilia 2005-11, Vol.11 (s1), p.7-10
Main Author: LUDLAM, C.
Format: Article
Language:English
Subjects:
Blood Coagulation Factor Inhibitors - blood
Factor VII - therapeutic use
Factor VIIa
haemophilia
haemostasis
haemostatic agent
Hemophilia A - therapy
Hemostasis, Surgical - methods
Humans
inhibitors
Male
management
orthopaedic surgery
Orthopedic Procedures
Recombinant Proteins - therapeutic use
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Summary:Until recently, surgery in haemophilia patients with inhibitors was strongly contraindicated and was therefore often not even contemplated. Inhibitor patients entering the surgical arena face unique challenges; the most frequently encountered problem during surgical intervention is bleeding, and thrombosis is occasionally observed. The activated prothrombin complex concentrate, FEIBATM, and recombinant activated factor VII (rFVIIa) are available as haemostatic cover during surgery. The use of rFVIIa enables inhibitor patients to undergo orthopaedic surgery with an expectation of success, and results are generally good. An organized team approach is critical to this success. However, further information is required to enable different procedures to be optimized in terms of both outcome and safety.
ISSN:1351-8216
1365-2516
DOI:10.1111/j.1365-2516.2005.01152.x