Recombinant Factor for VIIa for Uncontrolled Bleeding
Recombinant Factor for VIIa for Uncontrolled Bleeding
Coagulation factor VIIa (Recombinant) (rF.VIIa; NovoSeven) was approved for use in the United States by the Food and Drug Administration in March 1999 for the treatment of bleeding episodes in patients with hemophilia A or B with inhibitors to factor VIII or factor IX. Off-label use of rF.VIIa to control uncontrolled bleeding in different clinical scenarios has been reported in the literature.
Recombinant factor VIIa (rF.VIIa) has been used to control refractory bleeding peptic ulcer. It has also been used for uncontrolled bleeding after bowel surgery in patients suffering from Crohn disease and large bowel lymphoma with no previous history of coagulopathy. Patients with liver cirrhosis and coagulopathy who were given rF.VIIa avoided bleeding complications when their liver biopsies were performed. Administration of rF.VIIa controls the bleeding in trauma-related multitransfusion dilutional coagulopathy. It also stops uncontrolled nasal and dental bleeding in patients on warfarin.
We report our success in attaining hemostasis with the use of rF.VIIa in 2 patients having uncontrolled bleeding associated with liver cirrhosis and warfarin toxicity. Our experience includes further information on the use of rFVIIa in uncontrolled bleeding and may provide grounds for further investigation to extend the indication of rFVIIa. This will greatly enhance our capability to save lives in desperate situations.
Coagulation factor VIIa (Recombinant) (rF.VIIa; NovoSeven) was approved for use in the United States by the Food and Drug Administration in March 1999 for the treatment of bleeding episodes in patients with hemophilia A or B with inhibitors to factor VIII or factor IX. Off-label use of rF.VIIa to control uncontrolled bleeding in different clinical scenarios has been reported in the literature.
Recombinant factor VIIa (rF.VIIa) has been used to control refractory bleeding peptic ulcer. It has also been used for uncontrolled bleeding after bowel surgery in patients suffering from Crohn disease and large bowel lymphoma with no previous history of coagulopathy. Patients with liver cirrhosis and coagulopathy who were given rF.VIIa avoided bleeding complications when their liver biopsies were performed. Administration of rF.VIIa controls the bleeding in trauma-related multitransfusion dilutional coagulopathy. It also stops uncontrolled nasal and dental bleeding in patients on warfarin.
We report our success in attaining hemostasis with the use of rF.VIIa in 2 patients having uncontrolled bleeding associated with liver cirrhosis and warfarin toxicity. Our experience includes further information on the use of rFVIIa in uncontrolled bleeding and may provide grounds for further investigation to extend the indication of rFVIIa. This will greatly enhance our capability to save lives in desperate situations.
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