Open AccessRecombinant Factor VIIa: The Possibilities for Monitoring
Author(s) -
Escobar Miguel A.
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.tb00103.x
Subject(s) - recombinant factor viia , medicine , hemostasis , coagulation , factor viia , recombinant dna , thrombin , platelet , platelet activation , thrombin generation , pharmacology , immunology , anesthesia , tissue factor , biochemistry , chemistry , gene
SUMMARY Recombinant factor VIIa was developed for the treatment of bleeding in patients with hemophilia and inhibitors. Because of its unique mechanism of action, binding weakly to activated platelets independent of factors VIII or IX and enhancing factor X activation, systemic activation of the coagulation does not seem to occur. Thus, a local burst of thrombin induces hemostasis at the site of bleeding. The monitoring of this local event (thrombin generation) has not been developed. Assays that use non‐flow techniques, like the PT and aPTT, do not reflect physiological hemostatic conditions and have a limited application in the monitoring of rFVIIa. On the other hand, experimental models that use whole blood under shear force and that can indirectly measure thrombin generation may have a potential role in the monitoring of rFVIIa.