Factor IX replacement to cover total knee replacement surgery in haemophilia B: a single-centre experience, 2000-2010

Haemophilia : the Official Journal of the World Federation of Hemophilia
J UprichardT T Yee

Abstract

Total knee replacement (TKR) is a well recognized treatment for haemophilic arthropathy. Successful haemostasis can be achieved by bolus doses or continuous infusion (CI) using either recombinant (r) or plasma-derived (pd) factor IX (FIX). We retrospectively analysed our experience of factor replacement to cover TKR in haemophilia B patients and explored factors related to FIX use during surgery. Between 2000 and 2010, 13 primary TKRs were performed in 11 haemophilia B patients. Operations were performed by the same surgeon using standard techniques. Median age was 58 years (42-79). An adjusted CI protocol was used for 5 days followed by bolus doses. FIX:C was maintained at 100 IU dL(-1) in the immediate postoperative period. There was no excess haemorrhage. There was no evidence of thrombosis or infection. All patients received mechanical thromboprophylaxis and only one chemical. CI was used in seven cases. Ten patients received pdFIX. Median hospital stay was 14 days (8-17). Median factor usage was 999 IU kg(-1) (768-1248). During CI, factor consumption was 695 IU kg(-1), 691 IU kg(-1) and 495 IU kg(-1) for BeneFix®, Replenine® and Haemonine, respectively. Clearance of both pdFIX and rFIX reduced during CI. All operations wer...Continue Reading

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Citations

May 2, 2014·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·E Carlos Rodriguez-Merchan
Sep 6, 2012·Expert Opinion on Pharmacotherapy·Massimo FranchiniCarlo Bonfanti
Apr 10, 2015·Haemophilia : the Official Journal of the World Federation of Hemophilia·N SuzukiT Matsushita
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May 12, 2016·Blood Reviews·E Carlos Rodriguez-Merchan
Aug 3, 2016·Haemophilia : the Official Journal of the World Federation of Hemophilia·M A EscobarJ N Mahlangu
May 2, 2017·European Journal of Anaesthesiology·Sibylle A Kozek-LangeneckerKai Zacharowski
Aug 21, 2020·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Jerzy WindygaSrilatha Tangada
Feb 26, 2021·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Bartholomew J TortellaKaan Kavakli
Oct 7, 2021·Haemophilia : the Official Journal of the World Federation of Hemophilia·Mairead O'DonovanNiamh M O'Connell
Nov 4, 2021·Haemophilia : the Official Journal of the World Federation of Hemophilia·Chu Yang LinHaowei Linda Sun

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