A total of 168 procedures were performed in 66 children. Fifteen procedures (8%) in four children were performed in the presence of high-titre factor inhibitors. Procedures included central venous catheter (CVL) placement or revision (41%), otolaryngology procedures (23%), dental (11%), non-synovectomy orthopaedic procedures (8%), synovectomy (5%), circumcision (5%) and miscellaneous (7%). All patients received preoperative factor replacement (100% in haemophilia patients) followed by various factor replacement regimens postoperatively. No deaths or

see more life-threatening bleeding occurred with any procedure. Twelve of 168 procedures (7%) were complicated by bleeding. Tonsillectomy was the most common procedure complicated by haemorrhage 4 of 15 (26%) followed by nasal surgery (3/7 bleeds = 43%). The CVL surgeries were remarkably free of complications with only 1/69 (1.4%) with bleeding. Surgical procedures are safe in children with bleeding disorders with adequate planning and factor replacement. Bleeding remains

a problem in a subset of patients and requires ongoing haematological involvement and oversight. Delayed bleeding following T&A was especially common and suggests a need for close follow-up and ongoing factor coverage for this group of patients. “
“Summary.  Optimal doses of von Willebrand Factor/Factor VIII (VWF/FVIII) concentrates for surgical procedures in patients with VWD need to be determined. A prospective, multicenter study was performed that included an initial pharmacokinetic (PK) assessment following RXDX-106 ic50 a standard dose of VWF/FVIII concentrate (Humate-P®) to determine individual PK parameters and

guide therapeutic dosing during surgery. Forty one subjects received 60 IU kg−1 VWF: RCo. Median plasma levels, half-life, mean change from baseline and in vivo recovery (IVR) values were determined for VWF:RCo, VWF:Ag, and FVIII: C, and area Fenbendazole under the plasma time-concentration curve (AUC), mean residence time (MRT), clearance, volume of distribution and dose linearity were also assessed for VWF:RCo at various time points. Median baseline VWF:RCo level was 13 IU dL−1 (range, 6–124); with a mean change from baseline >100 IU dL−1 immediately after the infusion, decreasing to 10 IU dL−1 at 48 h postinfusion. The group median incremental in vivo recovery (IVR) for VWF:RCo was 2.4 IU dL−1 per IU kg−1, for VWF:Ag 2.3 IU dL−1 kg−1 and for FVIII:C was 2.7 IU dL−1 per IU kg−1. When analysing individual recovery values on repeated infusions, a very weak correlation was observed between presurgery IVR and IVR for both VWF:RCo and FVIII, measured at various times just prior to and after the surgical procedure. Although group median values were fairly consistent among repeated IVR measurements, the intra-individual IVR values for FVIII and VWF:RCo with repeated infusions showed a large degree of variability.