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Thromb Haemost 1994; 71(06): 737-740
DOI: 10.1055/s-0038-1642515
Review Article
Schattauer GmbH Stuttgart

Markers of Hypercoagulability in Patients with Hemophilia B Given Repeated, Large Doses of Factor IX Concentrates during and after Surgery

E Santagostino
1   Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Institute of Internal Medicine, IRCCS Maggiore Hospital and University of Milan, Italy
Department of Medicine, Beth Israel Hospital and Harvard Medical School Boston, MA, USA
,
P M Mannucci
1   Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Institute of Internal Medicine, IRCCS Maggiore Hospital and University of Milan, Italy
Department of Medicine, Beth Israel Hospital and Harvard Medical School Boston, MA, USA
,
A Gringeri
1   Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Institute of Internal Medicine, IRCCS Maggiore Hospital and University of Milan, Italy
Department of Medicine, Beth Israel Hospital and Harvard Medical School Boston, MA, USA
,
G Tagariello
2   Transfusion Center, Castelfranco, Veneto, Italy
Department of Medicine, Beth Israel Hospital and Harvard Medical School Boston, MA, USA
,
F Baudo
3   Hematology Division, Ca Granda Hospital, Milan, Italy
Department of Medicine, Beth Israel Hospital and Harvard Medical School Boston, MA, USA
,
K A Bauer
4   Charles A. Dana Research Institute and the Harward-Thorndike Laboratory, Boston, MA, USA
Department of Medicine, Beth Israel Hospital and Harvard Medical School Boston, MA, USA
,
R D Rosenberg
4   Charles A. Dana Research Institute and the Harward-Thorndike Laboratory, Boston, MA, USA
Department of Medicine, Beth Israel Hospital and Harvard Medical School Boston, MA, USA
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Publikationsverlauf

Received: 06. Januar 1994

Accepted after revision: 02. Februar 1994

Publikationsdatum:
09. Juli 2018 (online)

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Summary

Purer factor IX (FIX) concentrates have been produced for the treatment of hemophilia B in the attempt to reduce the risk of thrombotic complications associated with the use of prothrombin complex concentrates. To evaluate ex vivo whether or not FIX concentrates activate the coagulation system in conditions associated with a high risk for thrombosis, we measured markers of hypercoagulability in 10 patients with hemophilia B who underwent surgery, mainly orthopedic procedures, covered by multiple concentrate infusions (40-80 U/kg/day). Postinfusion plasma levels of prothrombin fragment 1+2 and factor X activation peptide did not differ significantly from the presurgical levels, neither before nor after each concentrate dose. Therefore, it appears that prolonged treatment of patients with hemophilia B undergoing high risk surgical procedures with high doses of FIX concentrate does not cause systemic activation of coagulation. This suggests that purified FIX concentrates are preferable to prothrombin complex concentrates for conditions associated with an increased risk of thrombosis.

 

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