Efficacy and safety of continuous infusion of Mononine® during five surgical procedures in three hemophilic patients

• Published in: American journal of hematology Vol. 58; no. 2; pp. 110 - 116
• Main Authors: Ménart, Christophe, Petit, Pierre Yves, Attali, Olivier, Massignon, Denis, Dechavanne, Marc, Négrier, Claude
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01-06-1998; Wiley-Liss
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; continuous infusion; factor IX; Factor IX - adverse effects; Factor IX - therapeutic use; hemophilia B; Hemophilia B - drug therapy; Hemorrhage - prevention & control; Humans; Infant, Newborn; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Postoperative Complications - prevention & control; Recombinant Proteins - adverse effects; Recombinant Proteins - therapeutic use; surgery; Surgical Procedures, Operative; Thrombosis - prevention & control; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Human; Blood product; Transfusion; Continuous; Hemophilia B; Male; Hemopathy; Genetic disease; Case study; Factor IX; Newborn; Treatment; Surgery; Adult; Concentrate; Coagulation factor; Coagulopathy
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/(SICI)1096-8652(199806)58:2<110::AID-AJH4>3.0.CO;2-V

We report here five surgeries successfully performed with a continuous infusion of Mononine® (Armour Pharmaceutical Company, Kankakee, IL) in three hemophilic B patients. Before surgery the patients received a bolus dose of 40 to 100 U/kg according to the type of surgery. This injection was followed by a continuous infusion of Mononine®, with an infusion rate of 3.5–7 U/kg/hr in order to maintain a factor IX level between 50 and 100% during the whole surgery and the following 6 days. The infusion rate was further adjusted according to the type of surgery until hospital discharge. This method appears to be safe and efficient, since no abnormal bleeding occurred during surgery and none of the patients presented any thrombotic complication. However, this alternative to intermittent administration of factor IX should be standardized and precisely evaluated, regarding the level and the amount of factor IX required, and the cost of the infused material. In our hands, this cost was decreased by 30–40% compared to previous therapeutic schedules at our institution. Am. J. Hematol. 58:110–116, 1998. © 1998 Wiley‐Liss, Inc.