The high cost of treating patients with inhibitors in an environment of restricted budgets warrants consideration of cost-effectiveness. We determined the clinical response, effect on quality of life and the cost-effectiveness of treatment with rFVIIa in six boys with long-standing inhibitors to factors VIII or IX, compared with other treatment regimes previously used in these patients. The stu...

OBJECTIVE To examine off-label recombinant factor VIIa (rFVIIa) use in pediatric patients including clinical indications, dose, adverse events, and outcomes. METHODS All pediatric patients entered into the Haemostasis Registry from 75 participating hospitals were analyzed. RESULTS Three hundred and eighty-eight pediatric patients received off-label rFVIIa from 2003 to 2009. Median age was 1...

To date, the majority of experience with recombinant factor VIIa (rFVIIa) has been in patients with hemophilia who developed autoantibodies (inhibitors) against factor VIII. This paper examines the reported experiences with rFVIIa use in non-hemophiliac pediatric-aged patients and is based on a review of the literature as well as an evaluation of isolated case reports and case series. The liter...

In trauma patients, resuscitation to endpoints below normal blood pressure (BP) levels may reduce further blood loss due to the rebleeding often caused by more aggressive resuscitation. However, patients whose BP is maintained at lower levels for extended periods are at increased risk for organ failure. The purpose of this study was to determine whether recombinant activated factor VII (rFVIIa)...

Despite the presence of normal coagulation values, refractory bleeding during extracorporeal membrane oxygenation (ECMO) is encountered. Occasionally, hemostasis is not achieved through traditional techniques including surgical exploration, anti-fibrinolytics, increasing fibrinogen level, increasing platelet counts, and decreasing activated clotting time (ACT). We report the case of an infant o...

BACKGROUND This report discusses a case of unsuccessful treatment with recombinant factor VIIa (rFVIIa) in off-label use. The need for international guidelines concerning the off-label use of rFVIIa is outlined as well as the need for methods to control the efficacy of rFVIIa objectively. CASE PRESENTATION 54 year old male with severe polymicrobial sepsis due to a perforated diverticulitis of...

BACKGROUND AND AIM Intraoperative blood loss is a frequent complication of hepatic resection and orthotopic liver transplantation. Recombinant activated coagulation factor VII (rFVIIa) is a coagulation protein that induces hemostasis by directly activating factor X. There is no clear information about the prophylactic value of rFVIIa in hepatobiliary surgery, specifically in liver resection and...

BACKGROUND Diffuse alveolar haemorrhage (DAH) is a serious pulmonary complication characterised by a high mortality rate and the absence of specific treatment. The intrapulmonary administration of activated recombinant factor VII (rFVIIa) in DAH was recently published in six patients by Heslet et al with an efficient hemostatic effect. We describe two cases of DAH treated with intrapulmonary rF...

BACKGROUND Activated prothrombin complex concentrate (aPCC) and recombinant Factor VIIa (rFVIIa) are 2 bypassing agents commonly used for treating acute bleeds in hemophiliac patients with inhibitors. A wide range of efficacy rates for aPCC and rFVIIa have been reported in a number of single-armed and randomized controlled comparative studies. OBJECTIVE The aims of this study were to compare ...

BACKGROUND Trauma is a leading cause of mortality and morbidity, with traumatic brain injury (TBI) and uncontrolled hemorrhage responsible for the majority of these deaths. Recombinant activated factor VIIa (rFVIIa) is being investigated as an adjunctive hemostatic treatment for bleeding refractory to conventional replacement therapy in trauma patients. TBI is a common component of polytrauma i...