A case report of hemorrhagic gastric cancer in a patient with hemophilia a usefullness of continuous infusion of recombinant factor VIII concentrate (octocog alfa) for intra- and postoperative hemostatic control at gastrectomy.

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  • 遺伝子組換え型第８因子濃縮製剤輸注により血友病の周術期管理を施行した出血性進行胃癌の１例

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Abstract

A 72-year-old man with hemophilia A complicated by massive hemorrhage from advanced gastric cancer was performed a radical operation by infusing a preparation of recombinant factor VIII (octocog alfa), and the hemostatic control was successfully made during and after the operation. The activity of factor VIII on admission was 16%. Distal gastrectomy with D2 lymph node dissection was performed with continuous infusion of the recombinant factor VIII (octocog alfa). Total volume of intraoperative hemorrhage was 670g, and no blood transfusion was aquired. The patient was transfused the recombinant factor VIII continuously with the 11th postoperative day to keep the range of activity of factor VIII within 60-80%. Total suture was removed on the 9th postoperative day. The continuous transfusion of the recombinant factor VIII has no risk of infection with any viruses and no adverse effects on the immune system. With the use of the therapy, surgery for patients with hemophilia A can be performed effectively and safely. This therapy will be increasingly used to offer useful perioperative hemostatic control for patients with hemophilia A.

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