Presurgical plasma exchange for severe factor V deficiency

We report two patients with severe congenital factor V deficiency, one of w hom also had a factor V inhibitor, who required correction of their coagulo pathy prior to surgical procedures. They underwent plasma exchange (PE) wit h fresh frozen plasma or solvent/detergent treated plasma (S/DP), with achi evement of factor V levels satisfactory for hemostasis for their procedures . PE makes it possible to raise factor levels quickly and sufficiently with out volume overload. In addition, transient reduction of inhibitor titers b y PE may improve the level of correction achievable during the perioperativ e period. The advent of S/DP promises to provide an added increment of safe ty in patients exposed to significant volumes of plasma during PE. (C) 2001 Wiley-Liss, Inc.