Varun Bafna: The Power of Extended Half-Life Factor IX in Enabling Safe Major Surgeries
Varun Bafna, Hematologist, Hemato-Oncologist and BMT Physician at Dr. Bafna Star Superspeciality Clinics, shared on LinkedIn:
”A rare and rewarding clinical experience in hemophilia care.
We recently managed an 81-year-old gentleman with severe Hemophilia B (FIX <1%, inhibitor negative) — possibly among the oldest patients to successfully undergo major orthopedic surgery in this setting.
Indication: Left gleno-humeral joint osteoarthritis secondary to recurrent hemarthrosis
Procedures: Left shoulder joint replacement plus prostate surgery
With meticulous perioperative planning, we administered a single pre-operative dose of Refixia (80 IU/kg; 4000 IU) 1–2 hours prior to incision.
- Surgery was completed successfully
- No intraoperative or postoperative bleeding complications
- No additional factor dosing required
- Post-operative course remained stable
- Inhibitor screening remained negative
This case highlights the power of extended half-life Factor IX in enabling safe major surgeries with reduced dosing burden — even in elderly hemophilia patients with advanced joint disease.
A special acknowledgment to the surgical team:
- Dr. Namdev Gorgille, Shoulder Specialist, Miraj
- Dr. Naaz Namaje, Anaesthetist
Looking ahead: With emerging therapies like Concizumab, there is growing evidence supporting prophylaxis in hemophilia (including inhibitor and non-inhibitor patients) to reduce bleeding episodes and prevent long-term joint damage.
Such approaches may further improve surgical readiness and outcomes in the future.
A step forward in advancing comprehensive hemophilia care.”
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