Practical aspects of factor concentrate use in patients with von Willebrand disease undergoing invasive procedures: a European survey.
BACKGROUND
The bleeding propensity in von Willebrand disease (VWD) is usually moderate or mild and patients with VWD do not need continuous treatment, but do require extra increased haemostatic cover when undergoing dental or surgical procedures. Desmopressin can be effective in certain patient groups and this has been considered in a previous publication.


OBJECTIVE
This paper now seeks to evaluate current knowledge and practice in the use of factor concentrate in the management of VWD patients undergoing invasive procedures.


METHODS
A literature search was performed on the use of factor concentrates to cover invasive procedures and a survey of current practice in a number of specialist haematology centres across Europe represented by the European Haemophilia Strategy Board was conducted.


RESULTS
Our review of the literature and the results of the survey showed considerable heterogeneity in treatment regimens, and a lack of consistency in reporting of the variables that determine factor concentrate dosing and monitoring.


CONCLUSIONS
By analysing the literature, examining guidelines and using consensus deliberation, this survey allowed the group to develop recommendations for management of VWD patients undergoing invasive procedures.
Department of Disorders of Hemostasis and Internal Medicine, Institute of Hematology and Transfusion Medicine, Warsaw, Poland. jwindyga@ihit.waw.pl.
J
J
Windyga
Haemophilia Unit, St Thomas' Hospital, London, UK.
G
G
Dolan
Servicio de Hematologia - Unidad de Hemofilia, Hospital Vall D'Hebron, Barcelona, Spain.
C
C
Altisent
Thrombosis and Haemostasis Unit, Laikon General Hospital, Athens, Greece.
O
O
Katsarou
Servicio Hematologia, Complexo, Hospitalario A Coruña, INIBIC, La Coruña, Spain.
M-F
MF
López Fernández
Department of Pediatric Hematology, Cerrahpasa Faculty of Medicine, Istanbul University, Cerrahpasa, Istanbul, Turkey.
B
B
Zülfikar
D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003029:Coagulants / Q000627:therapeutic use*; D016208:Databases, Factual; D004305:Dose-Response Relationship, Drug; D005169:Factor VIII / Q000032:analysis; D006801:Humans; D011182:Postoperative Care; D011300:Preoperative Care; D013927:Thrombosis / Q000188:drug therapy; D014148:Tranexamic Acid / Q000627:therapeutic use; D014842:von Willebrand Diseases / Q000188:drug therapy*; D014841:von Willebrand Factor / Q000032:analysis
D000933:Antifibrinolytic Agents; D003029:Coagulants; D014841:von Willebrand Factor; D014148:Tranexamic Acid; D005169:Factor VIII
factor concentrate; haemostatic cover; invasive procedures; survey; von Willebrand disease