Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review

Table 1

The recommended perioperative protocol established by the hematology department at our institution for an incisional biopsy of a mandibular bony lesion.

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(i) Infuse 100 units/kg (100%) of Mononine 15-30 minutes prior to the procedure through peripheral vein access

(ii) Check factor IX level and aPTT 15-30 minutes post-infusion (do not wait for level to come back to begin surgery)

(iii) Admit the patient for 24-hour observation

(iv) Infuse 50 units/kg (50%) of Mononine IV daily

(v) In the morning, obtain factor IX trough level (prior to infusion) and maintain trough level of 50-60%

(vi) If stable, discharge the patient with peripheral IV in place so that he can administer factor at home

Home schedule:

(vii) Infuse 50 units/kg (50%) of Mononine daily for 1 week, every other day for the following 2 weeks, then as needed for bleeding

(viii) Amicar 3,000 mg PO q6h for 7 days with the first dose the night before procedure

(ix) Follow up with the bleeding disorder clinic one week after biopsy

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