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Known Bleeding Disorders for Surgery

  • Miguel A. EscobarEmail author
  • Trinh Nguyen
Chapter

Abstract

Persons with congenital bleeding disorders pose a surgical challenge as hemostasis is already difficult without the added iatrogenic stress of surgery. For some bleeding disorders, there are therapeutic options including plasma-derived blood products and even recombinant factor products that are available. These may be administered pre- and post-op to prevent bleeding complications. Unfortunately for some rare bleeding disorders, there are no commercially available plasma-derived concentrates or recombinant products to administer pre- or postoperatively to prevent hemorrhagic sequelae. Fresh frozen plasma or cryoprecipitate becomes the only available option for surgical prophylaxis. A non-transfusional alternative such as desmopressin may be used with/without replacement factor to maintain hemostasis, depending on the individual response to desmopressin. Antifibrinolytics are another option as monotherapy or adjunctive therapy to prevent bleeding diathesis. The following discussion serves as a guide to the perioperative management of individuals with congenital bleeding disorders based on their diagnosis, type of surgery, and commercially available products.

Keywords

Congenital bleeding disorder Hemophilia Von Willebrand disease Fibrinogen Factor II Factor V Factor VII Factor VIII Factor IX Factor X Factor XI Factor XIII Surgery Prophylaxis Plasma-derived concentrates Recombinant factor FFP Cryoprecipitate Desmopressin Aminocaproic acid Tranexamic acid Fibrin 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of HematologyGulf States Hemophilia and Thrombophilia Center, University of Texas Health Center and McGovern Medical SchoolHoustonUSA
  2. 2.Department of PediatricsMD Anderson Children’s Cancer Center and Gulf States Hemophilia and Thrombophilia Treatment Center, The University of Texas-Health Science Center at HoustonHoustonUSA

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