The effect of recombinant factor VIIa (NovoSeven(R)) on peri-operative bleeding during total knee replacement in a non-hemophiliac patient.

Background. Recombinant factor VIIa has been in use for some time to control bleeding in persons with hemophilia. In the present study we describe our experience with the use of a commercial form of recombinant factor VIIa, NovoSeven(R) (Novo Nordisk, Denmark), to control perioperative bleeding in the course of total knee replacement on a patient who, though not hemophiliac, had a very low tolerance for blood loss. Case report. A 44-year-old patient with anemia and rheumatoid arthritis, with a history of significant perioperative blood loss was referred for total knee replacement. The employment of two relatively small doses of NovoSeven(R) caused a considerable decrease in peri-operative surgical site bleeding, and post-operative blood loss from the surgical wound within the first 20 hours after the procedure was easily controlled. No complications were encountered. Conclusions. NovoSeven(R) can be used safely and successively to control perioperative bleeding even in non-hemophiliac patients.