Canterbury DHB

Context

Surgery

Note: All surgery to be discussed with Regional Haematologist and treatment individualised. Liver or Renal biopsy to be referred to Regional Haemophilia Services.

In This Section

Minor Procedures - Endoscopy & Skin Lesions

Major Procedures - General or Orthopaedic Surgery

Minor Procedures - Endoscopy & Skin Lesions

Aim: To increase factor level to 50%.This is most easily achieved with a multiple dose schedule. Combine with an antifibrinolytic therapy.

Treatment Regimen

FVIII 25 - 30 u/kg, repeat dose at 24 hours and as required.

FIX 50 u/kg, repeat dose at 24 hours and as required

Tranexamic acid 1 g tds, 7 - 14 days.

Topical agents as required.

Major Procedures - General or Orthopaedic Surgery

Consultation between blood centre, surgeon, and haematologist is essential.

Prepare a written management protocol.

Ensure appropriate target levels by factor level monitoring.

Aim: To increase factor level to a target of 80-100% with trough level > 50%.

Treatment Regimen

Continuous infusion is most appropriate.

Alternatively, use:

FVIII 40 - 50 u/kg with post dose level available before/during surgery.

FVIII 25 u/kg 8 hours after start of surgery then 8 hourly for 24 hours.

FVIII 25 u/kg 12 hourly for 48 hours; pre/post dosing levels.

FVIII 20 u/kg daily 5 days.

FVIII 10 - 15 u/kg daily 5 - 7 days.

 

Total therapy for 10 - 14 days.

Monocomponent factor IX ( e.g.Mono FIX) for Haemophilia B (FIX deficient) patients.

About this Canterbury DHB document (5246):

Document Owner:

Mark Smith (see Who's Who)

Issue Date:

August 2016

Next Review:

August 2019

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5246