Liver resection appears safe in patients with hemophilia, VWD

Undergoing hepatectomy for the treatment of hepatocellular carcinoma in patients with von Willebrand disease or hemophilia A was found to be safe through the use of appropriate von Willebrand factor concentrate or recombinant factor VIII therapy, according to findings from a small study.

“The aim of the present study was to evaluate the safety of hepatectomy in patients with inherited blood coagulation disorders through appropriate coagulation factor replacement,” wrote Kosuke Kobayashi, MD, PhD, of the University of Tokyo and colleagues. The findings were published in Haemophilia.

The researchers retrospectively studied seven patients with hemophilia A and three patients with von Willebrand disease who underwent hepatectomy for the treatment of hepatocellular carcinoma. Specific regimens of von Willebrand factor concentrate or recombinant factor VIII therapy were administered perioperatively in these patients.

Study participants were matched in a 2:1 ratio to 20 patients without a bleeding disorder who also underwent hepatectomy. Various intraoperative and postoperative outcomes were compared between the two groups.

The researchers found no significant differences in estimated blood loss (P = .748), operative time (P = .359), or red blood cell transfusion rate (P = .605) between the bleeding disorder and nonbleeding disorder groups.

Additionally, there were no significant differences seen for mortality rate (P greater than .999) or major complication rate (P = .605).

“Even repeated hepatectomy can be safely performed in these patients, similar to patients without coagulation disorders,” the authors wrote.

Dr. Kobayashi and colleagues acknowledged two key limitations of the study were the small sample size and retrospective design.

“The administration protocol reported in the present study would certainly help surgeons when planning hepatectomy in patients with coagulation disorders,” they concluded.

No funding sources were reported. The authors reported having no conflicts of interest.

SOURCE: Kobayashi K et al. Haemophilia. 2019 May 29. doi: 10.1111/hae.13759.

Undergoing hepatectomy for the treatment of hepatocellular carcinoma in patients with von Willebrand disease or hemophilia A was found to be safe through the use of appropriate von Willebrand factor concentrate or recombinant factor VIII therapy, according to findings from a small study.

“The aim of the present study was to evaluate the safety of hepatectomy in patients with inherited blood coagulation disorders through appropriate coagulation factor replacement,” wrote Kosuke Kobayashi, MD, PhD, of the University of Tokyo and colleagues. The findings were published in Haemophilia.

The researchers retrospectively studied seven patients with hemophilia A and three patients with von Willebrand disease who underwent hepatectomy for the treatment of hepatocellular carcinoma. Specific regimens of von Willebrand factor concentrate or recombinant factor VIII therapy were administered perioperatively in these patients.

Study participants were matched in a 2:1 ratio to 20 patients without a bleeding disorder who also underwent hepatectomy. Various intraoperative and postoperative outcomes were compared between the two groups.

The researchers found no significant differences in estimated blood loss (P = .748), operative time (P = .359), or red blood cell transfusion rate (P = .605) between the bleeding disorder and nonbleeding disorder groups.

Additionally, there were no significant differences seen for mortality rate (P greater than .999) or major complication rate (P = .605).

“Even repeated hepatectomy can be safely performed in these patients, similar to patients without coagulation disorders,” the authors wrote.

Dr. Kobayashi and colleagues acknowledged two key limitations of the study were the small sample size and retrospective design.

“The administration protocol reported in the present study would certainly help surgeons when planning hepatectomy in patients with coagulation disorders,” they concluded.

No funding sources were reported. The authors reported having no conflicts of interest.

SOURCE: Kobayashi K et al. Haemophilia. 2019 May 29. doi: 10.1111/hae.13759.

Undergoing hepatectomy for the treatment of hepatocellular carcinoma in patients with von Willebrand disease or hemophilia A was found to be safe through the use of appropriate von Willebrand factor concentrate or recombinant factor VIII therapy, according to findings from a small study.

“The aim of the present study was to evaluate the safety of hepatectomy in patients with inherited blood coagulation disorders through appropriate coagulation factor replacement,” wrote Kosuke Kobayashi, MD, PhD, of the University of Tokyo and colleagues. The findings were published in Haemophilia.

The researchers retrospectively studied seven patients with hemophilia A and three patients with von Willebrand disease who underwent hepatectomy for the treatment of hepatocellular carcinoma. Specific regimens of von Willebrand factor concentrate or recombinant factor VIII therapy were administered perioperatively in these patients.

Study participants were matched in a 2:1 ratio to 20 patients without a bleeding disorder who also underwent hepatectomy. Various intraoperative and postoperative outcomes were compared between the two groups.

The researchers found no significant differences in estimated blood loss (P = .748), operative time (P = .359), or red blood cell transfusion rate (P = .605) between the bleeding disorder and nonbleeding disorder groups.

Additionally, there were no significant differences seen for mortality rate (P greater than .999) or major complication rate (P = .605).

“Even repeated hepatectomy can be safely performed in these patients, similar to patients without coagulation disorders,” the authors wrote.

Dr. Kobayashi and colleagues acknowledged two key limitations of the study were the small sample size and retrospective design.

“The administration protocol reported in the present study would certainly help surgeons when planning hepatectomy in patients with coagulation disorders,” they concluded.

No funding sources were reported. The authors reported having no conflicts of interest.

SOURCE: Kobayashi K et al. Haemophilia. 2019 May 29. doi: 10.1111/hae.13759.