Successful use of recombinant factor VIIa for hemostasis during total knee replacement in a severe hemophiliac with high-titer factor VIII inhibitor.

This is another case report of a successful use of rFVIIa in covering knee replacement surgery in a patient with severe hemophilia A and high-titer inhibitor. rFVIIa was given at a dose of 85 u/kg at 2-hourly interval initially, increasing the interval between infusions every 48 hours. Effective hemostasis was achieved. The authors recommend administering a dose of rFVIIa prior to removing the tourniquet and to initiate early post-operative aggressive physiotherapy when the level of factor VII is high.

– M. Aldouri.