Parents &
Carers
Surgery with inhibitors
Historically it has been very difficult to perform surgery on patients with inhibitors. Inhibitors make the control of bleeding during surgery more of a challenge, but do not necessarily prevent surgery.
The management of the surgical procedure will depend on the type of inhibitor the patient has, what the titre is and how the inhibitor responds to exposure to replacement clotting factor.
If a patient has a low titre inhibitor, surgery may be able to proceed in a similar way as for a haemophilia patient without an inhibitor (using replacement clotting factor). However, close monitoring during this event will be necessary as the patient will need a higher dose of replacement clotting factor to achieve the desired blood factor level and will probably need more frequent infusions. In addition, in recent years as experience with bypassing agents has improved, surgery is now possible even in patients with high-titre inhibitors.
This means that patients with major joint damage due to recurrent bleeding episodes can undergo joint replacement surgery (using bypassing agents). This can significantly improve the patient's mobility and quality of life.
