Perioperative use of recombinant activated factor VII in liver transplantation.
Recombinant activated factor VII (rFVIIa, NovoSeven, Novo Nordisk A/S, Denmark) is a treatment used to prevent and arrest intra- and postoperative bleeds in patients with haemophilia A or B complicated by circulating anticoagulants (inhibitors of FVIII and FIX). Patients who qualify for liver transplantation may have varying degrees of coagulation impairment, which may adversely impact elective anaesthetic and surgical procedures and elevate the risk of intraoperative bleeds, which require massive blood transfusions and worsen prognosis. Recently, reports have been published on the use of rFVIIa prior to surgical procedures, which are likely to cause severe blood loss as well as for so-called emergency therapy of coagulation disorders during liver transplantation.
Jureczko
L
L
Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Poland. jureczko@anest.pl
Kołacz
M
M
Trzebicki
J
J
Szyszko
G
G
Pacholczyk
M
M
Łagiewska
B
B
Chmura
A
A
Rowiński
W
W
Mayzner-Zawadzka
E
E
D000293:Adolescent; D000328:Adult; D001778:Blood Coagulation Disorders / Q000188:drug therapy; D015942:Factor VIIa / Q000627:therapeutic use*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000601:surgery; D006527:Hepatolenticular Degeneration / Q000097:blood / Q000601:surgery; D006801:Humans; D017093:Liver Failure / Q000097:blood / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011994:Recombinant Proteins / Q000627:therapeutic use
D011994:Recombinant Proteins; D015942:Factor VIIa