Use of recombinant activated factor VII for bleeding in pancreatitis: a case series.
OBJECTIVE
To describe the effects of recombinant activated factor VII (rFVIIa) in the treatment of bleeding in a series of patients with acute or chronic pancreatitis.


METHODS
Twelve patients (age, 2.5-65 years) with pancreatitis and bleeding were treated with 18.5 to 120 microg/kg of rFVIIa. Eight patients also had sepsis/infection and/or disseminated intravascular coagulation (DIC). The effects of rFVIIa on bleeding, coagulation status, and transfusion requirements were noted.


RESULTS
Bleeding stopped in 4 patients, was markedly reduced in 4 patients, was reduced in 3 patients, and was remained unchanged in 1 patient. For most patients with pre- and post-rFVIIa data, coagulation parameters improved and transfusion requirements reduced. No thrombotic adverse events occurred. Seven patients died for reasons considered to be unrelated to rFVIIa treatment.


CONCLUSIONS
This case series indicates that rFVIIa may be an effective hemostatic treatment of patients with pancreatitis suffering from massive bleeding. There were no thromboembolic events in any patient, including those with sepsis or DIC.
Laffan
Mike A
MA
Imperial College London, Hammersmith Hospital, London, United Kingdom. m.laffan@imperial.ac.uk
Tait
R Campbell
RC
Blatný
Jan
J
Espersen
Kurt
K
Grabowska
Izebelle
I
Loch-Bakoñska
Lidia
L
Pauzkowska
Agata
A
Stasiak-Pikula
Elzbieta
E
Michalska
Grazyna
G
Wendon
Julia
J
Piotrowska
Katarzyna
K
D000328:Adult; D000368:Aged; D001777:Blood Coagulation / Q000187:drug effects; D001803:Blood Transfusion; D002675:Child, Preschool; D005167:Factor VII / Q000008:administration & dosage*; D015942:Factor VIIa; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications*; D050500:Pancreatitis, Chronic / Q000150:complications*; D011994:Recombinant Proteins / Q000008:administration & dosage; D016896:Treatment Outcome
D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa