[Percutaneous nephrolithotripsy supported by recombinant factor VIII in a patient with hemophilia A, a Jehovah's Witness].

We reported the use of recombinant factor VIII (rF VIII) On two consecutive occasions of percutaneous nephrolithotripsy (PNL) for treatment of nephro-urethrolithiasis in a patient, a Jehovah's Witness, with hemophilia A. The patient refused blood transfusions but reluctantly accepted treatment with plasma-derived factor VIII concentrates. rF VIII was administered intravenously; 50U/kg just prior to PNL followed by a total dose of 37,500U of rF VIII within a week on each PNL. Hemostasis was complete on two occasions of PNL. The inhibitor to F VIII did not develop. rF VIII is considered to be an extremely useful for management of hemostasis during invasive surgery for patients with hemophilia A who refuse transfusions for religious reasons.