Transfusion medicine handbook

5. Fractionated Products

5.1 Coagulation Factors

National guidelines for the management of haemophilia, including von Willebrand disease (vWD), are available from the Haemophilia Centres or

https://media.starship.org.nz/nz-national-guidelines-for-the-management-of-haemophilia/NZ_National_Guidelines_for_the_Management_of_Haemophilia.pdf

Most patients diagnosed with haemophilia A and B have their treatment supervised by a specialist haematologist. For any individual patient, the various fractionated and recombinant products used in the management of haemophilia are not interchangeable without prior discussion with the treating haematologist.

The following guidelines are to assist in the immediate management of a patient until consultation with a specialist haematologist or NZBS Transfusion Medicine Specialist/ Medical Officer. The exact loading and maintenance dose and dosing interval should be based on the patient's clinical condition and previous response to therapy. Where possible, pre- and post-infusion factor assays should be carried out, at least for the first course of treatment. Coagulation factor therapy as a continuous infusion to cover surgical procedures should be administered under the supervision of a specialist haematologist and with laboratory tests performed to ensure that the desired plasma factor concentrations are achieved.