Total blood loss was 700 mL – comparable with this type of surgery in patients with no coagulopathies. Blood transfusion was not required. The patient was discharged 2 weeks after surgery with a completely healed wound. One year after surgery the hip was painless and the walking capacity improved markedly. Patient no 02 is a 44-year-old man with FVII baseline plasma level 3.5 IU dL−1. He has experienced numerous spontaneous and trauma-provoked bleeds to hips, knees and shoulders which were treated with FFP, PCC and rFVIIa. Recurrent

joint bleeds led to advanced arthropathy in shoulders yet the key problem for this particular patient was the painful left hip. The only concomitant disease was chronic hepatitis C with no signs of liver dysfunction. The cementless THR with ceramic articulation learn more was performed. The first dose of rFVIIa (25.8 μg kg−1) was given 15 min prior surgery. On D0 two additional doses of rFVIIa (12.9 μg kg−1) were given 8 and 16 h after the first injection. Through D1–D14 after surgery the patient received rFVIIa at a dose of 12.9 μg kg−1 every 12 h (Table 2).

FVII:C trough plasma levels in the post-operative days ranged from 5.5 to 8 IU dL−1 (on D1 – 7 IU dL−1). No bleeding complications occurred during the whole perioperative period. Total blood loss was 545 mL and blood transfusion was not required. The first dose of LMWH (enoxaparin 40 mg) was given 24 h after surgery. Thromboprophylaxis was continued for 14 days. The patient was discharged on day 15 after surgery with a AZD3965 nmr completely healed wound. Patient no 03 is 20-year-old woman with baseline FVII:C 8 IU kg−1. She had never experienced spontaneous bleeds but 3 years earlier she underwent surgery for left humeral selleck compound neck fracture that consisted in reduction of the

fracture and fixation with Rush pins. The surgery was complicated by excessive bleeding in the post-op period. At that time hypoproconvertinaemia was diagnosed. The fracture was healed in good position, yet the presence of Rush pins in a subacromial space provoked stiff shoulder requiring surgical intervention. The procedure consisted in shoulder arthroscopy with pins removal and scar tissue excision from the subacromial space. On D0 she received three doses of rFVIIa (18 μg kg−1) – the first just prior to surgery and two additional ones at 8 and 16 h after the first one. Through D1–D4 she received 18 μg kg−1 of rFVIIa every 12 h and through D5–D9 – the same dose every 24 h (Table 2). FVII:C trough plasma levels in the post-operative period ranged from 8 (on D7 and D9) to 49 IU dL−1 (D1). The post-op period was uneventful. The blood loss was 31 mL. No thromboprophylaxis was applied. The patient was discharged on day 11 after surgery with completely healed wound.