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March 16, 1970

Antihemophilic Factor VIII in Hemophilia: Use of Concentrates to Permit Major Surgery

Author Affiliations

From the sections of internal medicine (hematology), clinical pathology, and orthopedic surgery, Mayo Clinic and Mayo Foundation, and the Mayo Graduate School of Medicine (University of Minnesota), Rochester.

JAMA. 1970;211(11):1818-1823. doi:10.1001/jama.1970.03170110024004

Seven surgical procedures were successfully performed on five patients suffering from classic hemophilia. Hemostasis was maintained by the use of three factor VIII concentrates: cryoprecipitate, American National Red Cross high-purity concentrate, and a lyophilized glycine-precipitated fraction. Significant hemorrhage occurred twice, in each instance when the patient's factor VIII levels fell below 20% of normal. The availability of satisfactory concentrates of factor VIII permits consideration of elective surgical procedures in the hemophiliac. It should be emphasized, however, that such operations should be undertaken only if the indications are unequivocal and the necessary clinical and laboratory facilities are available.