caa a22 4500 477035019 CHVBK 20180405111302.0 cr unu---uuuuu 170330e19961101xx s 000 0 eng 10.1007/s002689900179 doi (NATIONALLICENCE)springer-10.1007/s002689900179 Surgery in Hemophilia A Patients with Factor VIII Inhibitor: 10-Year Experience [Elektronische Daten] [Romuald Scharf, Witold Kucharski, Tomasz Nowak] Abstract. Patients with hemophilia A and circulating anticoagulant (factor VIII inhibitor) present a difficult, even unsolvable problem, particularly if they require surgical treatment and the inhibitor titer is high. During the 1986-1995 period 29 surgical procedures on inhibitor hemophilia A patients were performed in our center. Each of the cases had an individual character, and all demanded special clinical treatment. Based on this experience we present the possibilities of hemostasis maintenance during the perioperative period with high doses of human or porcine factor VIII, aPCC, plasmapheresis, and extracorporeal antibody adsorption to protein A-Sepharose. In some patients hemostasis maintenance requires combined treatment. To induce immunotolerance in patients with inhibitor is the gold standard treatment because it is then possible to achieve proper hemostasis after factor VIII infusion. Various methods of immunotolerance induction have been discussed and compared with our experience with immunotolerance induction in 11 patients with small factor VIII doses (25 IU/kg twice a week) and the modified Malmö protocol in 15 patients.: 1996 by the Société Internationale de Chir, ugie Scharf Romuald Department of Surgery, Institute of Hematology and Blood Transfusion, 5 Chocimska Street, 00-957 Warsaw, Poland, PL aut Kucharski Witold Department of Surgery, Institute of Hematology and Blood Transfusion, 5 Chocimska Street, 00-957 Warsaw, Poland, PL aut Nowak Tomasz Department of Surgery, Institute of Hematology and Blood Transfusion, 5 Chocimska Street, 00-957 Warsaw, Poland, PL aut https://doi.org/10.1007/s002689900179 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900179 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Scharf Romuald Department of Surgery, Institute of Hematology and Blood Transfusion, 5 Chocimska Street, 00-957 Warsaw, Poland, PL aut NATIONALLICENCE 700 1- Kucharski Witold Department of Surgery, Institute of Hematology and Blood Transfusion, 5 Chocimska Street, 00-957 Warsaw, Poland, PL aut NATIONALLICENCE 700 1- Nowak Tomasz Department of Surgery, Institute of Hematology and Blood Transfusion, 5 Chocimska Street, 00-957 Warsaw, Poland, PL aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer