title: Successful total hip replacement with sequential administration of bypassing agents in an adolescent boy with hemophilia A and high inhibitor titers.
abstract: : There are only a few reports of total hip replacement in patients with hemophilia A and inhibitors. We performed total hip replacement in an 18-year-old adolescent boy who had high inhibitor titers since infancy. Recombinant factor VIIa (NovoSeven) was used as a bypass agent during the surgery. There was no excessive introperative bleeding; however, postsurgical bleeding occurred and was controlled by sequential administration of recombinant factor VIIa and activated prothrombin complex concentrate (FEIBA). This is the first report of this treatment modality in such a major surgery. Sequential bypassing agent therapy can be effective for treating refractory bleeding in hemophilia patients who have high inhibitor titers but require major surgery.
authors.affiliation: aUnit of Pediatric Hematology, Department of Pediatrics, Gazi University Medical Faculty bDepartment of Orthopedic surgery, Ankara, Turkey.
authors.forename: Zühre
authors.initials: Z
authors.lastname: Kaya
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Orhan
authors.forename: Sacit
authors.initials: S
authors.lastname: Turanlı
authors.forename: İdil
authors.initials: İ
authors.lastname: Yenicesu
authors.forename: Ülker
authors.initials: Ü
authors.lastname: Koçak
authors.forename: Türkiz
authors.initials: T
authors.lastname: Gürsel
mesh_terms: D000293:Adolescent; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D019774:Blood Coagulation Factor Inhibitors / Q000097:blood*; D001779:Blood Coagulation Factors / Q000627:therapeutic use*; D015942:Factor VIIa / Q000627:therapeutic use*; D006467:Hemophilia A / Q000097:blood* / Q000150:complications / Q000628:therapy; D006801:Humans; D008297:Male; D019106:Postoperative Hemorrhage / Q000097:blood / Q000209:etiology / Q000628:therapy; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D019774:Blood Coagulation Factor Inhibitors; D001779:Blood Coagulation Factors; D011994:Recombinant Proteins; C025667:prothrombin complex concentrates; C103587:recombinant FVIIa; D015942:Factor VIIa