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Although there is increasing reason to believe that the pathogenesis of classical hemophilia involves much more than deficiency of a plasma clotting factor,1 treatment of bleeding episodes remains firmly based upon the infusion of factor VIII.2 The rationale of plasma transfusion therapy has been well defined3 and assay procedures4,5 have been developed which permit an accurate diagnosis of hemophilia (hemophilia A), and, in addition, enable quantitative assessment of therapy. Nevertheless, treatment of this disorder still is beset with difficulties.
Large and frequent transfusions of fresh, freshfrozen, or reconstituted freeze-dried plasma are required to achieve and maintain hemostatic levels of factor VIII. Daily transfusions approximating one third of the patient's circulating plasma volume are required over a period of weeks to control hemorrhage following surgical procedures. Such massive plasma transfusions present the concomitant risk of circulatory overload. Moreover, prolonged plasma therapy limits the mobility of the patient
Simson LR, Oberman HA, Penner JA. Clinical Evaluation of Cryoprecipitated Factor VIII. JAMA. 1967;199(8):554–558. doi:10.1001/jama.1967.03120080088015
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