Perioperative Management of Hemophilia A With Recombinant VIII-SingleChain: A Case Series

Abstract

Patients with hemophilia A often experience non-traumatic spontaneous bleeding and prolonged time to hemostasis following trauma. Those who require surgery must undergo risk assessment for perioperative bleeding, and factor VIII (FVIII) replacement therapy must be administered when coagulation factors are deficient to prevent perioperative bleeding. This case series reports the first four cases in which single-chain recombinant FVIII (rVIII-SingleChain) was used for perioperative hemostasis management in patients with hemophilia A at Hiroshima University Hospital, Hiroshima, Japan. Three male patients, aged 70, 66, and 77 years, with mild hemophilia A underwent four surgical procedures. After surgery, rVIII-SingleChain administration provided adequate increases in factor VIII activity, measured by the one-stage clotting assay (OSA), and hemostatic effectiveness was observed. This case series demonstrates that real-time changes in coagulation factor activity in the perioperative period can be monitored with the OSA after rVIII-SingleChain administration in patients with hemophilia A.

J Curr Surg. 2022;12(1):15-20
doi: https://doi.org/10.14740/jcs455