Emergent Reversal of Anticoagulation Vitamin K Antagonist (VKA) and Direct Oral Anticoagulants (DOACs)

Please note: AABB reserves the right to make updates to this program.

Live Program Date: Wednesday, June 5, 2019 - On-Demand Available

Master Program Number: 19EL-442 (see program format numbers below under Registration)

Educational Track: Technical/Clinical
Topic: Transfusion Medicine
Intended Audience: Hospitals, Hospital Blood Banks, Medical Directors, Nurses, Physicians, Resident/Fellow, Students (MD, MT, SBB), Technologists, Transfusion Safety Officers
Teaching Level: Intermediate

Director/Moderator: Nancy M. Dunbar, MD, Associate Professor of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
Speakers: Ravi Sarode, MD, John H. Childers, MD, Professorship in Pathology, Professor (Tenure) of Pathology and Internal Medicine (Hematology/Oncology), Chief of Pathology and Medical Director, UTSW Clinical Laboratory Services, Director, Division of Transfusion Medicine and Hemostasis, UT Southwestern Medical Center, Dallas, TX; Jed Gorlin, MD, MBA, Medical Director and Vice President, Quality and Regulatory Affairs, Co-Director, Transfusion Medicine, Associate Clinical Professor, Laboratory Medicine and Pediatrics, Innovative Blood Resources, Hennepin County Medical Center, Children’s Hospitals and Clinics of Minnesota, University of Minnesota, St. Paul, MN

Learning Objectives

After participating in this educational activity, participants should be able to:

  • Discuss common clinical indications for the use of Four-Factor Prothrombin Complex Concentrate.
  • Compare and contrast alterative options for anticoagulant reversal including plasma and drug specific reversal agents.
  • Explore practical considerations for use of Four-Factor Prothrombin Complex Concentrate included fixed versus weight-based dosing.

Program Description

Four-Factor Prothrombin Complex Concentrate is used for reversal of vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) in the setting of major hemorrhage or urgent need for surgery. This program will describe the efficacy and safety of Four-Factor Prothrombin Complex Concentrate compared to plasma for VKA reversal prior to urgent surgical or invasive procedures. Practical considerations such as fixed versus weight-based dosing will also be explored. Direct oral anticoagulants (DOACs) are replacing VKA because of better safety profile and no need for routine testing. However, bleeding is still a serious complication of DOACs. The second part will discuss management of DOACs related bleeds and specific antidotes and non-specific agents.


   Program #
Single Viewer: On-Demand Register19EL-442-4035
Group Viewing: On-Demand Register19EL-442-8035

Continuing Education Credit

AABB designates both the live and on-demand version of this eCast each to be eligible for 1.0 continuing education credits/contact hours for Physicians, California Nurse, California Lab Personnel, Florida Lab Personnel and General Participation credit. The number and type of credits awarded for this program (both live and on-demand) was determined by the program duration. For more information on each credit type please visit our Continuing Education Credits webpage.

Disclosures for the planners of this event can be found here. Disclosures for the program faculty are provided at the beginning of the program.

Speaker Biographies

Dr. Jed Gorlin is board certified in Pediatrics and Blood Banking/Transfusion Medicine. Dr. Gorlin is the Medical Director and Vice President, Quality and Regulatory Affairs for Innovative Blood Resources. His education includes a BS at Stanford, MD at Yale, and MBA from University of Minnesota Carlson School of Business. He trained in Pediatrics and Pediatric Hematology/Oncology at Boston Children’s Hospital and completed research fellowships at Dana-Farber Cancer Institute, Massachusetts General Hospital, Brigham & Women’s Hospital, and the Puget Sound Blood Center. Dr. Gorlin served on the boards of AABB and the National Blood Foundation. He is an Associate Clinical Professor of Laboratory Medicine at the University of Minnesota. He is currently the co-director of Transfusion Medicine at Hennepin County Medical Center, a level one trauma hospital in Minneapolis, and Children’s Hospitals and Clinics in Minneapolis and St. Paul, MN. He is a consultant to AABB, CDC and NIH for projects in Rwanda, Tanzania and Central Asia including Kazakhstan and Kyrgyzstan. He was the AABB liaison to ACOG, AWHONN and CMQCC for obstetric hemorrhage.

Dr. Ravi Sarode is a Tenured Professor of Pathology and Internal Medicine (Hematology/Oncology), the Chief of Pathology, and the Medical Director of Clinical Laboratory Services at the University of Texas Southwestern Medical Center in Dallas. He is also the Medical Director of the Division of Transfusion Medicine and Hemostasis. He holds the John H. Childers, MD, Professorship in Pathology. Dr. Sarode has been actively involved in clinical research (Thrombotic Thrombocytopenic Purpura, Heparin Induced Thrombocytopenia, Therapeutic Apheresis in general and, red cell exchange in sickle cell anemia in particular, antiphospholipid antibody syndrome, platelet function disorders, reducing the misuse of blood products in clinical practice, Prothrombin Complex Concentrates, direct oral anticoagulants and, recently on rebalanced hemostasis of cirrhosis and restrictive transfusions). He has participated in 13 clinical trials, participated as a coordinating investigator for two completed international trials for Kcentra and leading another international clinical trial comparing Kcentra with Octaplex for VKA reversal for urgent surgery. He has published more than 170 articles and written 17 book chapters. He is a Co-Editor-in-Chief of “Transfusion and Apheresis Science”. He is the past president of the American Society for Apheresis (ASFA), and recipient of ASFA Presidential Award, Outstanding Physician Award at University Hospitals of Cleveland and the Vernie A. Stembridge Resident Teaching Award. He was honored as the “Choosing Wisely Champion” for his work on reducing unnecessary thrombophilia testing at annual American Society of Hematology meeting in San Diego 2016. He was invited to participate in writing guidelines by American Heart Association (2016-17) and Society for Interventional Radiology (2017-18) involving hemostasis and transfusions. He is a board member for “Foundation for Women and Girls with Bleeding Disorders” and co-chairs Hematology “Fellow’s work shop” at HTRS. His passion is to educate clinicians on appropriate use of blood components and laboratory testing to avoid harm to the patients, use limited resources judiciously and reduce healthcare cost.