Recombinant factor VIIa in orthotopic liver transplantation: influence on parameters of coagulation and fibrinolysis.
The effect of recombinant factor VIIa (rFVIIa) on blood loss was evaluated in cirrhotic patients undergoing orthotopic liver transplantation. In the present study, we explored the effect of rFVIIa on coagulation and fibrinolysis during orthotopic liver transplantation. Coagulation factors, parameters of thrombin generation and parameters of fibrinolysis were measured in six patients who had received a single dose of 80 micro g/kg rFVIIa and in ten controls, during and after orthotopic liver transplantation. Baseline concentrations and course of coagulation factors were similar in patients and controls. Thrombin generation did not rise after the administration of rFVIIa, but showed a sharp increase after reperfusion in patients, as compared with controls. No difference in fibrinolysis was apparent between patients and controls. No evidence of diffuse intravascular coagulation was seen. We conclude that the use of rFVIIa in orthotopic liver transplantation seems to enhance thrombin generation in a localized and time-limited matter, without causing systemic coagulation.
Meijer
Karina
K
Division of Haemostasis, Thrombosis and Rheology, Department of Haematology, University Hospital Groningen, The Netherlands. karinameijer@hetnet.nl
Hendriks
Herman G D
HG
De Wolf
Joost Th M
JT
Klompmaker
Ids J
IJ
Lisman
Ton
T
Hagenaars
Ans A M
AA
Slooff
Maarten J H
MJ
Porte
Robert J
RJ
van der Meer
Jan
J
D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects*; D001779:Blood Coagulation Factors / Q000032:analysis; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001792:Blood Platelets / Q000187:drug effects; D001803:Blood Transfusion; D004305:Dose-Response Relationship, Drug; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011994:Recombinant Proteins / Q000627:therapeutic use*; D013223:Statistics as Topic; D013917:Thrombin / Q000187:drug effects; D013997:Time Factors
D000933:Antifibrinolytic Agents; D001779:Blood Coagulation Factors; D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa; D013917:Thrombin