Abstract Number: PB0291
Meeting: ISTH 2020 Congress
Background: Vonicog alpha is a recombinant Von Willebrand Factor (rVWF) used in prevention of surgical bleeding in the Von Willebrand (VW) disease. The monitoring of its activity in clinical practice by the usual biological tests is not yet well established because of the presence of high molecular weight multimers. Moreover, most studies reporting the use of rVWF had combined the use of Factor VIII (FVIII).
Aims: To report our experience of rVWF use alone during surgeries in type 2 VW patients.
Methods: We report six cases of surgeries or delivery using rVWF: bilateral breast lumpectomy, colic polyp excision, carpal tunnel, circumcision, hip arthroscan and delivery. There was no use of FVIII and therefore, no hospitalization the day before the surgery. We administrated between 39 and 57 UI/kg of rVWF one hour before the interventions. We monitored the Factor VIII level, platelet closure time (PCT), VWF antigen (VWF:Ag) and VWF activity measured by ristocetin activity (VWF:RCo) one hour after the rVWF infusions. Except for the delivery where a single injection was administered, patients received an other injection of 20 to 45 UI/kg of rVWF between 12 and 24 hours after the surgery, depending of the hemorrhagic risk associated with the surgery. Injections were then continued or interrupted depending of the clinical condition and biological results. At the outside, one patient received 7 injections of rVWF for a total duration treatment of 10 days. Patients were hospitalized between 24 and 48 hours.
Results: We observed a correction of PCT with VWF :Ag and VWF: RCo > 100% one hour after the first rVWF infusions. No bleeding complications or thromboembolic events have been observed after surgeries. There was no adverse effects with the rVWF infusions.
Conclusions: rVWF effectively corrects hemostasis tests and reduces the number of injections compared to what was usually done with other VWF concentrates.
To cite this abstract in AMA style:Boukhlal S, Loeuillet C, Cogulet V, Galinat H, Pan-Petesch B. Use of Recombinant von Willebrand Factor Alone during Surgeries in Type 2 von Willebrand Patients: Case Reports [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/use-of-recombinant-von-willebrand-factor-alone-during-surgeries-in-type-2-von-willebrand-patients-case-reports/. Accessed December 5, 2021.
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