title: Pharmacokinetic-guided dosing of factor VIII concentrate in a patient with haemophilia during renal transplantation.
abstract: A 29-year-old man with severe haemophilia A and end-stage renal disease underwent a renal transplantation. To prevent bleeding, patient was treated with replacement therapy using factor VIII (FVIII) concentrate, according to National guidelines. Bayesian analysis was performed by combining observed FVIII concentrations with a population pharmacokinetic (PK) model for patients with severe haemophilia A in a perioperative setting. Application of Bayesian analysis led to accurate prediction of observed concentrations after prescribing dosing advice. We believe that PK-guided dosing of factor concentrates is a valuable step towards further individualisation of treatment in patients with bleeding disorders, especially in those patients requiring precise targeting of coagulation factor levels due to high risk of either bleeding or thrombosis, as illustrated by this patient undergoing a major surgical procedure.
authors.affiliation: Department of Paediatric Haematology, Erasmus University Medical Center-Sophia Childrens Hospital Rotterdam, Rotterdam, The Netherlands.
authors.forename: Hendrika C A M
authors.identifier: http://orcid.org/0000-0003-4988-0582
authors.initials: HC
authors.lastname: Hazendonk
authors.affiliation: Department of Haematology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Marieke J H A
authors.initials: MJ
authors.lastname: Kruip
authors.affiliation: Hospital Pharmacy-Clinical Pharmacology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Ron A A
authors.initials: RA
authors.lastname: Mathôt
authors.affiliation: Department of Paediatric Haematology, Erasmus University Medical Center-Sophia Childrens Hospital Rotterdam, Rotterdam, The Netherlands.
authors.forename: Marjon H
authors.initials: MH
authors.lastname: Cnossen