Why the study?
Perioperative management of severe congenital protein C deficiency remains unestablished, with few management methods available when anticoagulants must be discontinued.
Does prothrombin complex concentrate administration allow for successful perioperative management in patients with severe congenital protein C deficiency?
Does prothrombin complex concentrate administration allow for successful perioperative management in patients with severe congenital protein C deficiency?
Prothrombin complex concentrates may offer a feasible approach for the perioperative management of patients with severe congenital protein C deficiency who require discontinuation of standard anticoagulants.
May support PCC with PPSB-HT perioperatively in protein C deficiency; leaves open validation in larger studies.
Perioperative management of severe congenital protein C deficiency remains unestablished. This deficiency is often treated with anticoagulants, such as warfarin. Although anticoagulants need to be perioperatively discontinued, there are few methods for the management of such patients. We adopted a method for administering prothrombin complex concentrates (PCC), which includes intermittent administration of inactive protein C (PPSB-HT), and examined its outcome as a perioperative management approach for severe congenital protein C deficiency. Three patients underwent our perioperative management six times. We monitored activity levels of protein C, factor IX, and so forth. These patients could be perioperatively managed with PCC treatment.
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Inoue et al. (2021) studied this question.
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