Recombinant factor VIIa may reduce surgical blood loss and transfusion of blood products in cardiac surgery. However, the true risks of its use in this setting remains to be elucidated, especially when it is administered with other potent pro-haemostatic agents. We reviewed the recent literature on this topic and suggest that the off label use of recombinant factor VIIa is likely to continue. I...

Recent studies have shown a discrepancy between the level of tissue factor (TF) expression and the level of TF procoagulant activity on the apical and basolateral surface domains of polarized epithelial cells. The present investigation was performed to elucidate possible reasons for the discordant expression of TF and its activity on the surface of polarized epithelial cells using a human intes...

UNLABELLED We treated persistent hemorrhage after cardiopulmonary bypass in a heart transplant recipient who had received anticoagulation with the direct thrombin inhibitor bivalirudin by a combination therapy aimed at reducing the plasma concentration of the thrombin antagonist (hemodialysis and modified ultrafiltration), increasing the concentration of thrombin at bleeding sites (recombinant ...

Recombinant factor VIIa (rFVIIa) is a novel prohemostatic drug for patients with hemophilia who have developed inhibitory antibodies. The postulation has been made that hemophilia is not only a disorder of coagulation, but that hyperfibrinolysis due to a defective activation of thrombin activatable fibrinolysis inhibitor (TAFI) might also play a role. In this in vitro study, the potential of rF...

We present a case of an atrial septal defect repair under cardiopulmonary bypass in a child with factor VII deficiency. A four-year-old girl, with the diagnosis of secundum atrial septal defect, was referred to surgery. Coagulation tests showed an international normalized ratio of 2.4. Further investigations revealed deficiency of factor VII with 42% activity. Fifteen minutes before the inducti...

Recombinant activated factor VII is commonly used for the treatment of hemophiliac patients with inhibitors and has been studied for use in trauma. We report the use of recombinant activated factor VII for a male patient who was injured in a motor vehicle accident. We also summarize the animal studies and clinical trials that have been reported.