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Practical aspects of DDAVP use in patients with von Willebrand Disease undergoing invasive procedures: a European survey.

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Windyga, Jerzy Dolan, Gerry Altisent, Carme Katsarou, Olga López-Fernández, María Fernanda Hermans, Cédric [UCL]

INTRODUCTION: Desamino D-arginine vasopressin (DDAVP or desmopressin) is a useful and effective haemostatic treatment for patients with von Willebrand Disease (VWD). However, there are still issues regarding in which subtypes of VWD DDAVP is appropriate and little consensus on its use in different surgical settings. We also lack information concerning the appropriate laboratory parameters that should be monitored. AIM: The European Haemophilia Therapy Strategy Board (EHTSB) wished to investigate published information and clinical use of DDAVP in VWD patients. METHODS: We conducted a literature survey on management of VWD during surgical interventions and undertook a survey of specialist haematologist centres across Europe to assess current management of VWD patients. RESULTS: DDAVP is ineffective in type 3 VWD and its use in type 2B remains controversial due to the possibility of thrombocytopenia. It can, however, be used effectively to cover minor surgery and dental procedures in most other VWD patients. For major surgery there is wider use of factor concentrate in preference to DDAVP depending on the subtype of VWD. We give consensus recommendations on the use of DDAVP for surgical interventions in VWD including laboratory parameters that denote an adequate response and contraindications to its use. CONCLUSIONS: DDAVP can be recommended to cover invasive procedure in selected patients with VWD, however, we need more information and systematic recording of adverse events associated with DDAVP use in VWD. A companion paper will be published covering the use of factor concentrates in VWD patients.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2016
Language Anglais
Journal information "Haemophilia : the official journal of the World Federation of Hemophilia" - Vol. 22, no.1, p. 110-120 (2016)
Peer reviewed yes
Publisher Blackwell Science ((United Kingdom) Oxford)
issn 1351-8216
e-issn 1365-2516
Publication status Publié
Affiliations UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire
UCL - (SLuc) Service d'hématologie
MESH Subject Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Deamino Arginine Vasopressin ; Europe ; Female ; Humans ; Infant ; Male ; Middle Aged ; Practice Guidelines as Topic ; Surveys and Questionnaires ; Young Adult ; von Willebrand Diseases
Keywords DDAVP-haemostatic cover ; surgical intervention ; von Willebrand disease
Links
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Bibliographic reference Windyga, Jerzy ; Dolan, Gerry ; Altisent, Carme ; Katsarou, Olga ; López-Fernández, María Fernanda ; et. al. Practical aspects of DDAVP use in patients with von Willebrand Disease undergoing invasive procedures: a European survey.. In: Haemophilia : the official journal of the World Federation of Hemophilia, Vol. 22, no.1, p. 110-120 (2016)
Permanent URL http://hdl.handle.net/2078.1/208408