Clotting Factor Replacement for Hemophilia
Hemophilia is primarily treated by replacing the absent or abnormal clotting factors to prevent severe blood loss and complications from bleeding. Clotting factors are replaced by injecting (infusing) a clotting factor replacement into the veins. Infusions of clotting factors help blood to clot normally and prevent damage to muscle, joints, and organs.
There are different types of blood clotting factor replacement.
Fresh frozen plasma is the liquid part of blood (plasma) taken from a donor and frozen for later use.
Cryoprecipitate is a blood product that has many clotting factors, so it can also be used to treat many kinds of bleeding problems.
Factor concentrates are used to prevent or treat bleeds that happen outside a hospital.
What To Expect After Treatment
The infusion of clotting factor stops bleeding within hours, although the exact amount of time varies. Heavy bleeding takes longer to control than light bleeding. If the proper amount of replacement factors is given, bleeding will stop normally.
Why It Is Done
Clotting factors can treat bleeding episodes or prevent bleeding before surgeries and activities that may cause bleeding.
Clotting factor replacement can be done in one of two ways:
For help on the decision to have regularly scheduled or on-demand clotting factor replacement, see:
How Well It Works
With on-demand treatment, you can give yourself a shot to quickly control bleeding. You can give yourself a shot before you begin activities where there is a high risk of bleeding. To stop internal bleeding from causing long-term damage to joints, you must replace clotting factors promptly.
With regularly scheduled treatment, you likely will have fewer bleeds if you get clotting factor on a regular schedule. This is especially important if you have severe hemophilia.
Virus infection from donated clotting factor. The risk of getting a virus from donated clotting factor is very low. If you use clotting factor that is made in a lab, you have almost no risk of getting an infection. Clotting factor that is made in a lab is also called recombinant clotting factor.
Donated blood also goes through purification processes that destroy viruses that are not found with tests.
Some viruses are harder to detect even with careful screening. People who receive many units of donated blood factor concentrate over their lives have a slightly increased risk of getting one of these viruses. For example, hepatitis A and parvovirus (the virus that causes fifth disease) are harder to detect. They can sometimes be spread by donated blood.
Inhibitors. Some people develop antibodies to the injected clotting factor. These antibodies are called inhibitors. If you develop inhibitors, the usual forms of clotting factors may not effectively prevent or stop bleeding. Children are more likely to develop inhibitors than adults.
For more information about inhibitors, see Hemophilia: Treatment for People With Inhibitors.
What To Think About
With regularly scheduled treatment, clotting factor must be injected into a vein every few days. It may be hard to stay on schedule with the injections.
Adults and parents of children who have hemophilia can learn to inject replacement clotting factors. Children may also be taught to infuse themselves with clotting factors by age 10. Younger children and those who have developed antibodies (inhibitors) may not be able to infuse themselves.
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