Prophylactic and therapeutic use of recombinant activated factor VII in patients with cirrhosis and coagulation impairment

Abstract Patients with cirrhosis and impaired coagulation often pose major therapeutic problems during bleeding episodes or invasive procedures. Recombinant activated factor VII (rFVIIa), which has been licensed for the treatment of haemophilia patients with factor VIII or IX inhibitors, has been oc...

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Published in:	Digestive and liver disease Vol. 39; no. 5; pp. 490 - 494
Main Authors:	Tsochatzis, E, Papatheodoridis, G.V, Elefsiniotis, I, Thanelas, S, Theodossiades, G, Moulakakis, A, Archimandritis, A.J
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Ltd 01-05-2007
Subjects:	Adult Aged Blood Coagulation Disorders - drug therapy Cirrhosis Coagulopathy Factor VIIa - therapeutic use Female Gastroenterology and Hepatology Humans Liver Cirrhosis - drug therapy Male Middle Aged Recombinant factor VII Treatment Outcome Cirrhosis Coagulopathy Recombinant factor VII
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Summary:	Abstract Patients with cirrhosis and impaired coagulation often pose major therapeutic problems during bleeding episodes or invasive procedures. Recombinant activated factor VII (rFVIIa), which has been licensed for the treatment of haemophilia patients with factor VIII or IX inhibitors, has been occasionally used in cirrhotic patients. We present five patients with cirrhosis and coagulopathy who received 1–4 recombinant activated factor VII infusions either prophylactically in order to safely undergo an invasive procedure or therapeutically in order to control a severe bleeding episode which did not respond to standard supportive care. In particular, recombinant activated factor VII infusions were given in two patients before a percutaneous liver biopsy, in one patient before teeth extraction and in two patients with haemoperitoneum after an invasive procedure. Infusions of recombinant activated factor VII achieved rapid correction of prothrombin time in all cases allowing the safe performance of invasive procedures or resulting in efficient control of the bleeding episode. In conclusion, recombinant activated factor VII seems to be a rather promising agent for the prevention or treatment of complications of haemostasis impairment in cirrhotic patients. However, its exact role in this setting needs to be evaluated within well-designed, controlled clinical trials.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1590-8658 1878-3562
DOI:	10.1016/j.dld.2006.05.015