BleedQ

vwd

Last updated:

What is the type of VWD-related bleeding?

Surgical bleed

This is a scenario-based simulator. No patient information should be entered, and the tool does not record what you enter.

What is the type of surgery?

Major surgery

Major SurgeryI.e. knee/hip replacement, inguinal hernia repair, adenoidectomy and tonsillectomy

Is major surgery confirmed?

Yes

Last updated: 16-JUL-2026
SOURCE
  • Wilate PM, 2025
  • ASH ISTH NHF WFH Management Guidelines, 2021
Wilate is approved in Canada for this use
treat

Loading and Maintenance Dosing

  1. 1

    Wilate loading dose 40–60 IU/kg 1-2 hours before start of procedure.

  2. 2

    Wilate maintenance dose 20–40 IU/kg every 12–24 hours as required

Plasma level of VWF: RCo of ≥60 IU/dL (≥60%) and FVIII:C of ≥40 IU/dL (≥40%) should be achieved. The dosage should be adjusted according to the extent and location of the bleeding and/or the type of surgery. In VWD type 3 patients, especially in those with gastrointestinal (GI) bleedings, higher doses may be required.

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Acknowledgments Adapted from the wilate product monograph and the 2021 ASH ISTH NHF WFH management guidelines, with clinical oversight by Dr.

Minor surgery

Minor SurgeryI.e. dental surgery of 1 or more teeth excluding 3rd molar(s) extraction, synovectomy excluding knee joint synovectomy, dermatological removal procedures, electrocoagulation, gastroscopy, polypectomy, and ERCP.

Is minor surgery confirmed?

Yes

Last updated: 16-JUL-2026
SOURCE
  • Wilate PM, 2025
  • ASH ISTH NHF WFH Management Guidelines, 2021
Wilate is approved in Canada for this use
treat

Loading and Maintenance Dosing

  1. 1

    Wilate loading dose 30–60 IU/kg 1-2 hours before start of procedure.


  2. 2

    Wilate maintenance dose 20–40 IU/kg every 12–24 hours as required.

Plasma level of VWF: RCo of ≥60 IU/dL (≥60%) and FVIII:C of ≥40 IU/dL (≥40%) should be achieved. The dosage should be adjusted according to the extent and location of the bleeding and/or the type of surgery. In VWD type 3 patients, especially in those with gastrointestinal (GI) bleedings, higher doses may be required.

Scenario complete

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AcknowledgmentsAdapted from the wilate product monograph and the 2021 ASH ISTH NHF WFH management guidelines, with clinical oversight by Dr.

Severe recurrent bleeding

This is a scenario-based simulator. No patient information should be entered, and the tool does not record what you enter.
SOURCE
  • ISTH SCC, 2026
Defining severity VWF level ≤ 20IU/dL (antigen or activity) confirmed on 2 or more occasions AND a bleed history that is spontaneous, recurrent or prolonged, attributed to VWD, and including at least one of the following:
ANY

  1. 1

    Arthropathy resulting from prior joint bleeding

  2. 2

    Prolonged bleeding (current or historical) requiring medical intervention

  3. 3

    A pattern of excessive menstrual bleeding requiring medical intervention

  4. 4

    A bleeding event (current or historical) requiring medical intervention, of one of the following types:

    • Joint bleeding
    • Intracranial bleeding
    • Intraspinal bleeding
    • Gastrointestinal bleeding
    • Retroperitoneal bleeding
    • Other bleeding deemed severe by a patient's hematologist
Probable severe VWDFor individuals with VWF ≤ 10IU/dL but no major bleeding history, if the absence of bleeding history may be due to young age, limited hemostatic challenges, continuous prophylactic treatment.

Is severe recurrent bleeding due to VWD confirmed?

Yes

Last updated: 16-JUL-2026
Source
  • Connell, 2026
  • ASH ISTH NHF WFH Management Guidelines, 2021
  • Wilate PM, 2025
Wilate is the only VWF concentrate approved in Canada for this use if DDAVP is ineffective or contraindicated
Patient eligible for prophylaxisA period of at least 3 to 6 months of treatment administered at least once weekly, or for women with HMB, at least once per menstrual cycle.
Treat

Prophylaxis dosing

  1. 1

    Wilate 20-40 IU/kg BW 2-3 times per week

Exact dosing should be determined by the severity of VWD and by the patient’s clinical status and response.

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AcknowledgmentsAdapted from the wilate product monograph and the 2021 ASH ISTH NHF WFH management guidelines, with clinical oversight by Dr.

Major bleed episode

This is a scenario-based simulator. No patient information should be entered, and the tool does not record what you enter.
Any

Bleeding results in

  1. 1

    Hospitalization

  2. 2

    Surgical procedure

  3. 3

    PRBC transfusion

  4. 4

    Hgb decrease> 2g/dL

  5. 5

    Involves bleeding in critical areas (Intracranial, Intraspinal, Pericardial, Retroperitoneal, Intramuscular with compartment syndrome)

  6. 6

    Is recurrent and disruptive (affecting the ability to attend normal schooling, working, or social activity)

Is major bleed due to VWD confirmed?

Yes

Last updated: 16-JUL-2026
SOURCE
  • Connell, 2026
  • Wilate PM, 2025
Wilate is approved in Canada for this use if DDAVP is ineffective or contraindicated
Treat

On-demand dosing

  1. 1

    Loading dose: Wilate 40–60 IU/kg

    Maintenance dose: Wilate 20–40 IU/kg every 12–24hrs*


    *This may need to be continued for up to 5–7 days for major hemorrhages.

Maintaining trough levels of at least 0.50 IU/mL is reasonable until hemostasis is achieved.

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AcknowledgmentsAdapted from the wilate product monograph and Connell NT, 2026, with clinical oversight by Dr.

Minor bleed episode

This is a scenario-based simulator. No patient information should be entered, and the tool does not record what you enter.
Bleed that is non-major, non-recurrent, and unrelated to surgical procedure (i.e. mild forms of epistaxis, oral bleeds, menorrhagia.)

Is minor bleed due to VWD confirmed?

Yes

Last updated: JUL-16-2026
SOURCE
  • Connell, 2026
  • ASH ISTH NHF WFH Management Guidelines, 2021
  • Wilate PM, 2025
Wilate is approved in Canada for this use if DDAVP is ineffective or contraindicated

Managing minor bleeding

IF

If type 1 >0.30 IU/mL, type 2A and type 2M with confirmed responsiveness

THEN
Desmopressin

Consider: Tachyphylaxis, free water intake restrictions, serum sodium monitoring

IF

Type 1/ Type 2A/2M VWF <0.30 IU/mL

THEN
Perform a trial of desmopressin and treat based on the results

Instead of treating with TXA or VWF first

IF

Bleeding involving mucosal sites

THEN
Antifibrinolytic therapy

i.e tranexamic acid

IF

Bleeding does not respond quickly to therapies above and supportive measures.

THEN

Dose as needed

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AcknowledgmentsAdapted from the wilate product monograph and Connell NT, 2026, with clinical oversight by Dr.

What is the type of VWD-related bleeding?

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For HCP only. Content does not constitute medical advice and is not a substitute for clinical judgment. T&C apply