A study in respect of transfusion related complications in hemophiliacs with special reference to developing factor inhibitors

Authors : Praveen Sharma

DOI : 10.18231/j.ijpo.2020.046

Volume : 7

Issue : 2

Year : 2020

Page No : 243-247

Prophylaxis and treatment with factor replacement have greatly improved the quality of care for
patients with hemophilia.However, development of factor inhibitors is the most serious and challenging
complication of therapy. Other complications are viral infections like Hepatitis B, Hepatitis C, and HIV,
and the other infective diseases, which can be transmitted by the blood and blood products transfusion.
The aims of this study is to study the complications in the hemophiliacs who have been treated
prophylactically or ‘on demand’ with fresh frozen plasma, cryoprecipitate and concentrated products of
FVIII and
During the study period, all patients (100) with Hemophilia attending Gandhi Medical College are taken
under consideration. The presence of an inhibitor was determined by a simple mixing experiment using the
test plasma and normal pooled plasma and 3rd generation enzyme linked immunosorbent assay (ELISA)
method& anti-HBsAg.statistical
The inhibitor study showed that in 7%(3.2-13.98 at 95% confidence interval) patients, APTT was not
corrected after mixing patients plasma with pooled normal plasma (PNP) and applying the test immediately
and after one hour of incubation. serological tests showed antibodies for HCV were positive in 4% of cases
(1.1%-9.93% at 95% CI), whereas antibodies against HBsAg was positive in 1% of cases(0.3%-5.45% at
95% CI), which was less then anti HCV. Transfusion associated complications were higher in severe form
of Haemophilia as compared to moderate and mild form of Hemophilia.
Developing antibodies to infused factor concentrates (inhibitors) remains a major source of morbidity and
mortality in the treatment of patients with hemophilia. Novel treatment approaches for these patients are
in developmental stage, which include therapeutic agents that mimic factor VIII or augment thrombin
production by bypassing the inhibitors, as well as agents that act by inhibiting the natural anticoagulants.

Keywords: Activated partial thromboplastin, time(APTT), Coagulation factor, Hemophilia, Inhibitor.


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