A Case of a Patient with Hemophilia a Who Underwent Hepatic Resection with Management by Continuous Administration of Factor VIII

Abstract

Hemophilia A is a disease characterized by bleeding tendency due to abnormal coagulation factor VIII. Thereare few reports on perioperative management during hepatic resection. In this report, we describe a case in whichliver resection was safely performed in a hemophilia A patient by continuous perioperative administration of factor VIII. The patient, an 82-year-old man, was found to have a 32 mm hepatocellular carcinoma in the S8 of theliver during follow-up of chronic hepatitis C. The liver damage was A, APTT was prolonged to 62.3 seconds, andfactor VIII activity was decreased to 7%. Preoperative administration of Factor VIII confirmed improvement incoagulability, and partial hepatectomy was performed. Postoperatively, the needed factor VIII dose was estimatedby APTT and administered continuously. There were no postoperative complications. If immediate measurementof factor VIII activity was difficult, perioperative management was possible by continuous administration of factorVIII under APTT monitoring.