Open AccessThe Use of Recombinant Factor VIIa in Patients Undergoing Liver Transplant
Author(s) -
Escobar Miguel A.,
Hoots W. K eith
Publication year - 2003
Publication title -
transfusion alternatives in transfusion medicine
Language(s) - English
Resource type - Journals
eISSN - 1778-428X
pISSN - 1295-9022
DOI - 10.1111/j.1778-428x.2003.tb00099.x
Subject(s) - medicine , recombinant factor viia , liver transplantation , placebo , coagulopathy , adverse effect , incidence (geometry) , surgery , clinical trial , factor viia , transplantation , blood transfusion , randomized controlled trial , anesthesia , coagulation , physics , alternative medicine , pathology , tissue factor , optics
SUMMARY Liver transplantation is often associated with substantial blood loss and coagulopathy that requires the need for transfusion of large amounts of blood products with increased morbidity and mortality. Recombinant factor VIIa (rFVIIa) was originally developed for the treatment of hemophilia patients with antibodies to factors VIII or IX. More recently rFVIIa has been studied as a prohemostatic agent in a variety of clinical and surgical conditions including liver transplantation. A review of the literature reveals a total of 96 cases of liver transplantation including recipient infants and adults. The doses of rFVIIa have been variable, as well as the results. The largest study was a randomized, double blind, parallel group placebo controlled trial with 83 patients who received a single dose of rFVIIa or placebo. No statistical correlation was seen between the use of rFVIIa and transfusion requirement. The overall incidence of adverse events has been low in all the reported cases. Further large controlled studies should be performed before the widespread use of rFVIIa in the surgical setting is advocated.