Any Experience Using Wilate to Rx Von Willebrand's Preop/Periop?

[Jay K]

Anybody with experience using Wilate prophylactically perioperatively for management of VWD?

I'm not having much success in finding consistent dosing regimens/schedules for perioperative use.

There's dosing schedules for treatment of episodes of bleeding minor/major.

There's this:

http://www.ncbi.nlm.nih.gov/pubmed/21437358

One source indicates dosing 1-2 hrs presurgical, but then mentions achieving levels of VWF:RCo of 60 IU/dl ( 60%) and FVIII:C levels of 40 IU/dl ( 40%). I'm not certain those assays are possible to obtain immediately after dosing yet within a timely presurgical window. Any suggestsions?

What's your experience or practice?

Desmopressin's ineffective in this scenario.

Thanks for the insight.

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[DrBeaker]

My hospital has Humate-P. the dose to give was calculated by the patients hematologist. I gave the dose and had to draw blood to send for FVIII level an hour after infusion. The Humate needs to be in 30-60 min prior to incision. Why doesn't this pt have a hematologist?

 

[DrBeaker]

Another study I read regarding Humate was a 40-60IU/kg loading dose. Maintenance was half the loading dose given 8-12 hours later? Also antifibrinolytics are ok to use with the vwf FVIII concentrates