Failure of factor VIII inhibitor bypassing activity (Feiba) to secure haemostasis in haemophilic patients with antibodies.

Parry, D. H.; Bloom, A. L.

doi:10.1136/jcp.31.11.1102

Cited by 32 publications

(15 citation statements)

References 20 publications

(18 reference statements)

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“…4,5,12,15,22,[25][26][27] This process is divided into 3 phases: exudative, where fibrin development occurs; proliferative, which is characterized by the occurrence of fibroblastic and capillary proliferation; and reparative, evidenced by collagen synthesis and osteogenesis. 1 Studies have demonstrated that fibrin exerts at least two functions on a wound repair: homeostasis and stimulus to the proliferation of perivascular fibroblasts.…”

Section: Discussionmentioning

confidence: 99%

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Effects of fibrin sealer and resorbable gelatin on the repair of osseous defects in rat tibia

2007

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Efeitos de selante de fibrina e de gelatina absorvível no reparo de defeitos ósseos em tíbia de rato Abstract: Gelfoam  -a biologically resorbable gelatin sponge -has the function of restricting hemorrhage, providing platelet rupture, and supporting fibrin threads. Beriplast  -a fibrinogen-thrombin compound -is used to adhere tissues, to consolidate sutures and in hemostasis. The objective of this study was to perform a histological analysis of the effects of haemostatic agents on osseous repair. These materials were inserted into surgical sites in young rat right and left tibiae. After the observation periods of 7, 14, 30 and 45 days, according to the bioethic protocol, the animals were killed, the tibiae were removed and fixed in 10% formalin and decalcified in equal parts of formic acid and sodium citrate solutions. After routine processing, the specimens were embedded in paraffin for microtomy. Analysis of the results demonstrated that the haemostatic agents are effective in controlling hemorrhage; they stimulate osteogenesis, featuring a pattern of osseous tissue formation similar to the control pattern, although the amount of osseous trabeculae was superior, especially in the Gelfoam group in the periods of 7 and 14 days; 30 days after surgery, the delay in tissue healing in the control group in relation to the experimental groups started to decrease, and the control and experimental groups exhibited similar tissue repair after 45 days, when all the groups exhibited secondary osseous tissue. Descriptors: Fibrin foam; Fibrin tissue adhesive; Osteogenesis; Rats; Tibia. Resumo: Gelfoam -uma esponja de gelatina biologicamente reabsorvível -tem por função coibir as hemorragias, promover o rompimento de plaquetas e sustentar a rede de fibrina. Beriplast P  -um composto de fibrinogênio-trombina -é usado na adesão de tecidos, consolidação de suturas e hemostasia. O objetivo deste estudo foi verificar histologicamente os efeitos de agentes hemostáticos na reparação óssea, os quais foram colocados em lojas cirúrgicas nas tíbias direita e esquerda de ratos jovens. Após os perío-dos de observação de 7, 14, 30 e 45 dias, segundo o protocolo bioético, os animais foram sacrificados, as tíbias foram removidas e fixadas em formalina a 10% e descalcificadas em partes iguais de soluções de ácido fórmico e citrato de sódio, para inclusão em parafina e microtomia. A análise dos resultados demonstrou que os agentes hemostáticos têm eficá-cia no controle hemorrágico; eles estimulam a osteogênese, provocando um padrão de formação de tecido ósseo semelhante ao padrão do grupo controle, embora a quantidade de trabéculas ósseas tenha sido superior principalmente no grupo do Gelfoam, nos períodos de 7 e 14 dias; após os 30 dias da cirurgia, o retardo na reparação tecidual do grupo controle em relação aos grupos experimentais começou a decrescer, tornando-se a reparação tecidual daquele semelhante à destes aos 45 dias, quando todos os grupos apresentaram tecido ósseo secundário.

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Section: Discussionmentioning

confidence: 99%

“…4,5,12,15,22,[25][26][27] The presence of antibodies against coagulation factors or against platelets (immunothrombocytopenia) may impair the possibility to correct the defect in some patients. 13,16 In patients that are prescribed oral anticoagulants, the correction of the coagulation defect may be hazardous.…”

Section: Introductionmentioning

confidence: 99%

Effects of fibrin sealer and resorbable gelatin on the repair of osseous defects in rat tibia

2007

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“…With the treatment of 3 plasma volumes (the usually recommended daily treat ment, which for an average plasma volume of 2,500-3,000 ml takes around 5h effective treatment time) it may be expected to regularly reduce inhibitor levels of 60-70 BU/ ml to below 10 BU/ml. With plasma exchange, on the other hand, mostly 2 or more treatment days have been required to bring down inhibitor levels initially no higher than 20-60 BU/ml [10][11][12][13], With prompt extensive removal of inhib itor, bleedings should be manageable with controlled dos ing of factor Vili or IX, which is safer than depending or arbitrary administration of PCC:s or APCC:s [6] or the more recently introduced factor VIIa [28]. However, there is a limitation to the level that can be reduced to below 10 BU/ml within 1 day; in our estimation it is unlikely that patients with levels exceeding 200 BU/ml could reach a level below 10 BU/ml, even if treatment is extended to 5-6 plasma volumes.…”

Section: Discussionmentioning

confidence: 99%

“…Initially these preparations were mostly re ported to have a high rate of success in controlling bleeding episodes [4,5], but some studies failed to confirm the he mostatic effect and indicated them to be less effective than factor VIII was in normally responsive hemophiliacs [6,7], Porcine factor VIII has been used with satisfactory results Since the preferred treatment for all hemophiliacs is the administration of human factor Vili or IX, removal of inhibitors has been tried prior to the infusion of factor preparations. Early attempts with plasma exchange sug gested that antibody removal contributed to the successful clinical outcome reported for some patients [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Kinetic Aspects of the Removal of IgG and Inhibitors in Hemophiliacs Using Protein A Immunoadsorption

Gjörstrup¹,

Berntorp²,

Larsson³

et al. 1991

Vox Sanguinis

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Seven patients with hemophilia A and B and 3 patients with acquired hemophilia were treated on 13 and 4 occasions, respectively, with protein A immunoadsorption to reduce anti-factor Vili or IX antibodies. Usually the patients were treated on 2 consecutive days. On each treatment day an average of 3 (range: 1.02-5.83) plasma volumes were processed in the congenital patients and 1.5 (range: 1.02-2.90) in those with acquired hemophilia. Plasma levels of IgG decreased from 18.9 ±1.9 to 3.1±1.2g/l in the congenital group, and from 11.5 ±2.3 to 2.3±0.6g/l in the acquired group. In the congenital hemophiliacs a corresponding reduction in inhibitor level of 70-95% was regularly seen; in 1 exceptional patient the inhibitor was reduced from 4,350 to 12 Bethesda Units/ml (BU/ml) during 5 days of treatment. In the congenital hemophiliacs immunoadsorption was followed by factor infusion to peak levels between 8 and 215 IU/dl. In the patients with acquired hemophilia a satisfactory reduction in inhibitor levels was obtained in 2 of the 4 treatments, which were followed by DDAVP or factor infusion. Some recommendations for the use of protein A immunoadsorption in the treatment of hemophilic patients will be given.

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“…The presence of factor Vila cannot be ignored, especially in preparations that have high factor VII clotting activity, which can be tested by the relatively simpler method of Seligsohn et al [137]. cessful use of these activated concentrates, some investigators [117,120] have noticed unsuccessful responses in their patients and bleeding could not be controlled. Among a few patients who were successfully treated by Stenbjerg and Jorgensen [146], the plasma of 1 patient was found resistant to factor IX concentrate in an in vitro study and 1 patient showed evidence of DIC.…”

Section: Tests For the Detection Of Potential Thrombogenicitymentioning

confidence: 99%

Prothrombin Complex Concentrates for Clinical Use

Chandra¹,

Brummelhuis²

1981

Vox Sanguinis

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Prothrombin complex concentrates prepared for clinical use are reviewed with emphasis on frequently observed adverse reactions such as viral hepatitis and thromboembolic complications. Preparation procedures and quality control are described briefly, and the use of these concentrates in the treatment of hemophilia A patients who develop factor VIII inhibitors is also described. The causes of and methods for the detection of potential thrombogenicity are discussed and suggestions which may result in a safer product are made.

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Failure of factor VIII inhibitor bypassing activity (Feiba) to secure haemostasis in haemophilic patients with antibodies.

Cited by 32 publications

References 20 publications

Effects of fibrin sealer and resorbable gelatin on the repair of osseous defects in rat tibia

Effects of fibrin sealer and resorbable gelatin on the repair of osseous defects in rat tibia

Kinetic Aspects of the Removal of IgG and Inhibitors in Hemophiliacs Using Protein A Immunoadsorption

Prothrombin Complex Concentrates for Clinical Use

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