AM25-TU-20-L - Transfusion Medicine and Blood Bank Practice Guidelines for Von Willebrand Disease

Proposed Session Description: Von Willebrand disease (vWD) diagnosis is difficult to make due to the number and complexity of tests involved. In addition, interpretation is patient and test dependent. Certain patient populations with vWD are especially challenging including OB and pediatric neonates, due to their physiological changes. It is important to appreciate how blood components especially cryoprecipitate can play a critical role in treatment of bleeding in VWD given it has VWF, Fibrinogen and FVIII in comparison to other treatment options.

This session will outline recent guidelines and key recommendations for laboratories involved in diagnosing von Willebrand disease (ie. For patients without bleeding symptoms, a von Willebrand factor level below 0.30 IU/mL is recommended to confirm a diagnosis of type 1 VWD. In patients with abnormal bleeding, a VWF level below 0.50 IU/mL is advised to confirm the diagnosis). The session will also focus on pitfalls of diagnostic testing for von Willebrand Disease (vWD) that may affect the accuracy and interpretation of test results with emphasis on the differences in current assays and newly automated methods with overview of various clinic conditions, medications, time of testing, and sample handling issues.

Additionally, we will discuss the implications of this diagnose for the blood bank. For example, blood product allocation for delivery planning and/or amniocentesis during pregnancy for women with vWD. Furthermore, we will discuss the risk of postpartum hemorrhage and knowledge of the other various treatment modalities that are immediately available to stop the bleeding. We will also discuss special blood bank consideration when vWD individuals undergo surgery and might not have received optimal treatment prior to surgery.

Lastly, we will address creating standardized protocols for pregnancy delivery with vWD so that healthcare providers and blood bank can provide needed treatments in a timely manner and outline additional recommendations to reduce bleeding risks to improve outcomes, ensuring safer surgeries and healthier pregnancies.