1. Recombinant factor VIIa in orthotopic liver transplantation: influence on parameters of coagulation and fibrinolysis.
- Author
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Meijer K, Hendriks HG, De Wolf JT, Klompmaker IJ, Lisman T, Hagenaars AA, Slooff MJ, Porte RJ, and van der Meer J
- Subjects
- Adult, Blood Coagulation Factors analysis, Blood Loss, Surgical prevention & control, Blood Platelets drug effects, Blood Transfusion, Dose-Response Relationship, Drug, Factor VIIa, Female, Humans, Liver Cirrhosis blood, Liver Cirrhosis surgery, Male, Middle Aged, Pilot Projects, Statistics as Topic, Thrombin drug effects, Time Factors, Antifibrinolytic Agents therapeutic use, Blood Coagulation drug effects, Factor VII therapeutic use, Fibrinolysis drug effects, Liver Transplantation methods, Recombinant Proteins therapeutic use
- Abstract
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.
- Published
- 2003
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