Replacement therapy is a treatment that replaces something that's missing or not working well in your body. People with von Willebrand's disease don't have von Willebrand factor, or it doesn't work well enough to help clot their blood. So shots (injections) of plasma and clotting factor VIII plus von Willebrand factor can be used as replacement therapy. Doctors prescribe this type of therapy to people who do not respond well to desmopressin medicine or who
have a very severe form of von Willebrand's disease. Patients often learn to inject themselves at home, but a doctor or nurse can give the shots too.
Plasma is usually taken from blood donations. In the
United States, donated blood is carefully screened. Blood with any viruses,
such as the human immunodeficiency virus (HIV) or
viral hepatitis B, is not used. The chance of getting one of these viruses from plasma is extremely low. Most forms of plasma, such as
Humate-P, Koate-DVI, and Alphanate, are screened and treated for viruses.
Alphanate is not available in the U.S.
Replacement therapy doesn't always work well, because the body
may kill the newly introduced von Willebrand factor.
Research is being done on new medicines that contain a
greater amount of von Willebrand factor.