The Food and Drug Administration has approved antihemophilic factor-von Willebrand factor complex (human) (Alphanate) for use in patients with von Willebrand disease (types 1 and 2) who have to undergo invasive procedures or surgery. Von Willebrand disease, the most common inherited bleeding disorder, is caused by a deficiency in the von Willebrand factor (factor VIII in the clotting of blood, known also as the antihemophilic factor), which in normal clotting helps platelets aggregate and adhere to the blood vessel wall. Antihemophilic factor-von Willebrand factor complex (human) is purified from pooled human plasma from screened and tested U.S. donors and contains the clotting proteins that are either deficient or defective in patients with von Willebrand disease. Use of the drug has been shown to diminish the risk of bleeding during surgical procedures. It's already approved for the prevention and control of bleeding in surgical patients deficient in factor VIII secondary to hemophilia A or who have acquired factor VIII deficiency. It hasn't been approved for use in patients with severe von Willebrand disease (type 3) who need major surgery.

The first-line choice for managing surgery in patients with von Willebrand disease is desmopressin (DDAVP and others); the use of antihemophilic factor-von Willebrand factor complex (human) is restricted to those in whom desmopressin use is either ineffective or contraindicated.

Nurses working in the operating room should be aware of the use of antihemophilic factor-von Willebrand factor complex (human) and its possible adverse effects (itching, pharyngitis, paresthesia, headache, swelling of the face, and rash and chills).