Dental invasive procedures in von Willebrand disease outpatients treated with high purity FVIII/VWF complex concentrate (Fanhdi®): experience of a single center

Valeria De Padua; Umberto Romeo; Cristina Santoro; Riccardo Bosco; Erminia Baldacci; Antonietta Ferretti; Francesco Malaspina; Maria Gabriella Mazzucconi; Domenico Gaglioti

doi:10.1016/j.heliyon.2020.e03426

Dental invasive procedures in von Willebrand disease outpatients treated with high purity FVIII/VWF complex concentrate (Fanhdi®): experience of a single center

Heliyon. 2020 Feb 25;6(2):e03426. doi: 10.1016/j.heliyon.2020.e03426. eCollection 2020 Feb.

Authors

Valeria De Padua¹, Umberto Romeo¹, Cristina Santoro², Riccardo Bosco¹, Erminia Baldacci², Antonietta Ferretti², Francesco Malaspina², Maria Gabriella Mazzucconi², Domenico Gaglioti¹

Affiliations

¹ Department Head-Neck, Sapienza University, Rome, Italy.
² Department of Cellular Biotechnology and Hematology, Sapienza University, Rome, Italy.

Abstract

Purpose: To retrospectively assess the effectiveness and safety of customized hemostatic protocols using a plasma-derived, von Willebrand Factor (VWF)-containing Factor VIII concentrate (pdVWF/FVIII) in von Willebrand disease (VWD) patients undergoing dental invasive procedures.

Methods: Protocol for each patient was drawn up by the Blood Unit based on the VWD type, disease severity, and type of treatment. pdFVIII/VWF infusions and doses were registered at 30-60 min before intervention (t0) and at 12-24-36-48-72 h after intervention (t12-t72) and up to day 7. Any peri- or postoperative bleeding, complication or adverse event was registered.

Results: Forty-five dental procedures were performed on 20 VWD patients (six type-1, two type-2a, six type-2b, six type-3). Most pdFVIII/VWF infusions at t0 were 60 IU/kg (n = 7) and 50 IU/kg (n = 9). Subsequent infusions were mostly 30-50 IU/kg. No bleeding complications or adverse events were reported.

Conclusion: This study supports the safety and efficacy of pdFVIII/VWF to prevent peri- and postoperative bleeding after invasive oral procedures.

Keywords: Coagulation factor VIII; Dental materials; Dental surgery; Dentistry; FVIII/VWF concentrate; Oral medicine; Oral surgery; Periodontics; Postoperative bleeding; Prosthetic dentistry; Surgery; von Willebrand disease; von Willebrand factor.