{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:16:57Z","timestamp":1788171417568,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n Patients with von Willebrand disease (VWD) undergoing surgery require von Willebrand factor (VWF) and factor VIII (FVIII) supplementation for adequate haemostasis. Plasma\u2010derived clotting factor concentrates differ in their VWF:FVIII activity ratios: high\u2010ratio product (HRP, 10:1), intermediate\u2010ratio product (IRP, 2.4:1), and low\u2010ratio product (LRP, 1:1). These differences may affect FVIII kinetics.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This single\u2010centre observational study included VWD patients undergoing surgery, treated with an HRP, IRP, or LRP, and with \u22652 perioperative VWF or FVIII measurements between 2009 and 2024. VWF and FVIII trajectories were assessed using linear mixed\u2010effects models. Secondary endpoints were bleeding and venous thromboembolic events (VTE).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 123 patients were included; 63% underwent major surgery. Twenty\u2010four patients received HRP, 61 received IRP and 38 received LRP. The median number of infusions was three across groups. Incremental VWF recoveries were 1.7\u00a0IU\/dL per IU\/kg for HRP, 1.3 for IRP, and 2.4 for LRP. FVIII recoveries were 2.5 for IRP and 2.7 for LRP. Over time, HRP showed higher mean VWF levels than IRP (\u039426 IU\/dL;\n p<\/jats:italic>\n = 0.010). HRP was associated with higher FVIII levels compared with IRP (\u039448 IU\/dL;\n p<\/jats:italic>\n < 0.001) and LRP (\u039435 IU\/dL;\n p<\/jats:italic>\n = 0.021). No difference was found between IRP and LRP. In patients receiving three consecutive infusions in 24\u00a0h, FVIII levels remained higher with HRP than IRP (\u039438 IU\/dL;\n p<\/jats:italic>\n = 0.019). No VTEs occurred.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n IRP and LRP led to greater initial VWF and FVIII peaks, whilst HRP produced more sustained FVIII elevation. Recognising these kinetic differences may guide tailored perioperative management of patients with VWD.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hae.70386","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:37:11Z","timestamp":1788169031000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative von Willebrand Factor and Factor VIII Kinetics in von Willebrand Disease Patients Treated With Different Clotting Factor Concentrates"],"prefix":"10.1111","author":[{"given":"Zo\u00eb A.","family":"Gras","sequence":"first","affiliation":[{"name":"Center For Benign Haematology, Thrombosis and Haemostasis Van Creveldkliniek University Medical Center Utrecht University Utrecht Utrecht Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey Z. L.","family":"Kuppens","sequence":"additional","affiliation":[{"name":"Center For Benign Haematology, Thrombosis and Haemostasis Van Creveldkliniek University Medical Center Utrecht University Utrecht Utrecht Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger E. G.","family":"Schutgens","sequence":"additional","affiliation":[{"name":"Center For Benign Haematology, Thrombosis and Haemostasis Van Creveldkliniek University Medical Center Utrecht University Utrecht Utrecht Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"issue":"2","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1182\/blood.V69.2.454.454","article-title":"Epidemiological Investigation of the Prevalence of von Willebrand's Disease","volume":"69","author":"Rodeghiero F.","year":"1987","journal-title":"Blood"},{"issue":"6","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/S0022-3476(05)80384-1","article-title":"Prevalence of von Willebrand Disease in Children: A Multiethnic study","volume":"123","author":"Werner E. J.","year":"1993","journal-title":"Journal of Pediatrics"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102516.2010.02320.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538\u20107836.2006.02146.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/BLOODADVANCES.2020003264"},{"key":"e_1_2_11_7_1","unstructured":"Nederlandse Vereniging voor Hematologie.Richtlijn Ziekte van Von Willebrand. (2024)."},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13451"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200008173430702"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12498"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(95)90166\u20103"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.15079"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH11\u201002\u20100057"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538\u20107836.20sss09.03678.x"}],"container-title":["Haemophilia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.70386","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hae.70386","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.70386","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:37:12Z","timestamp":1788169032000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hae.70386"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":13,"alternative-id":["10.1111\/hae.70386"],"URL":"https:\/\/doi.org\/10.1111\/hae.70386","archive":["Portico"],"relation":{},"ISSN":["1351-8216","1365-2516"],"issn-type":[{"value":"1351-8216","type":"print"},{"value":"1365-2516","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"assertion":[{"value":"2026-05-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hae.70386"}}