In a pharmacokinetic study with Humate-P including six patients with various types of von Willebrand disease, a median half-life of 11.3 h for vWF:RCoF and of 15.2 h for vWF:Ag was found. The median value of in vivo recovery (IVR) was estimated for vWF:RCoF as 2.10 IU dL-1 plasma per 1 substituted IU kg-1 b.w. (or 73%), for vWF:Ag as 1.88 IU dL-1 plasma per 1 substituted IU kg-1 b.w. (or 69%); and for FVIII:C as 2.69 IU dL-1 plasma per 1 IU kg-1 b.w. (or 99%). Transient postinfusion shortening or normalization of previously prolonged bleeding time was observed in all patients. In a retrospective study involving 97 patients with various von Willebrand disease types, clinical efficacy and safety of treatment with Haemate-P in 73 surgical interventions, 344 separate bleeding events, 93 other events and 20 cycles of prophylactic treatment were evaluated. The clinical efficacy was rated good to excellent in 99% of the surgeries, in 97% of the bleeding episodes, in 86% of the other events, and in all prophylactic treatments. The overall tolerability was good. Adverse events possibly or probably associated with use of Humate-P/Haemate-P were rare, of non-serious nature and mild to moderate in their intensity.
A 71-yr-old male was seen because of the development of severe bleeding diathesis secondary to an acquired factor V inhibitor. The lack of clinical and laboratory response to fresh frozen plasma prompted us to treat him with platelet transfusions during 4 separate bleeding episodes; on each occasion he received 1 0-1 5 U of homologous platelet concentrates. There was a remarkable clinical response associated with a marked correction of the prolonged prothrombin time. prolonged partial thromboplastin time. and prolonged Russell viper venom time; this correlated with higher factor V levels and complete neutralization of the inhibitor. The beneficial effect of platelet transfusion lasted 5-6 days. The inhibitor was of low titer. and it was precipitated by staphylococcal protein A. The in vivo response to platelet transfusion correlated with subsequently performed in vitro experiments. Nonwashed control platelet pellets mixed with inhibitor plasma partially corrected the prolonged PTT. whereas washed platelets or albumin density gradient separated
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