Recombinant activated factor VII for coagulopathy in fulminant hepatic failure compared with conventional therapy

@article{Shami2003RecombinantAF,
  title={Recombinant activated factor VII for coagulopathy in fulminant hepatic failure compared with conventional therapy},
  author={Vanessa M Shami and Stephen Hugh Caldwell and Elizabeth E. Hespenheide and Kristen O. Arseneau and Stephen J Bickston and Barbara Gail Macik},
  journal={Liver Transplantation},
  year={2003},
  volume={9}
}
Severe coagulopathy in fulminant hepatic failure (FHF) is difficult to correct by conventional means. Recombinant activated factor VII (rFVIIa) is an antihemophilic factor that has shown promise in treating coagulopathy in liver disease. Our aim is to review our experience with rFVIIa in treating the coagulopathy of FHF and compare these results with those of conventional therapy. Fifteen patients with FHF who met King's College criteria for orthotopic liver transplantation were studied. All… 
FVIIa corrects the coagulopathy of fulminant hepatic failure but may be associated with thrombosis: A report of four cases
TLDR
It is concluded that rF VIIa is effective in the correction of the coagulopathy associated with FHF However, thrombotic events are of concern and therefore, further studies are warranted to define the safety of rFVIIa in that setting.
Recombinant factor VIIa: unregulated continuous use in patients with bleeding and coagulopathy does not alter mortality and outcome.
TLDR
It is concluded that unregulated continuous administration of rFVIIa in bleeding/coagulopathic patients did not alter outcome, and closer monitoring of r FVIIa usage, including hematology consultation and enforcement of pre-rF VIIa blood component usage would optimize cost-effectiveness.
The use of recombinant factor VIIa in liver diseases
TLDR
There is not enough evidence to support the extensive use of recombinant activated factor VII in the treatment of bleeding complications of liver disorders, and further large randomized, controlled clinical trials are needed.
Clinical Usefulness of Recombinant Activated Factor VII in Patients with Liver Failure Undergoing Invasive Procedures
Objective: To evaluate the use of recombinant activated factor VII (rFVIIa) in patients with liver failure undergoing invasive procedures. Methods: An OVID/MEDUNE and PubMed search (1997-June 2011)
Recombinant factor VIIa: life-saving therapy in a patient with massive bleeding and hepatic failure
TLDR
In patients with life-threatening bleeding and hepatic failure a more generalised decrease in the vitamin K dependent clotting factors must be considered, with most of the time disproportionally low levels of factor VII.
The Use of Activated Recombinant Factor VII in a Patient with Fulminant Hepatic Failure Requiring Placement of an Intracranial Pressure Monitor
TLDR
The use of rFVIta for rapid decrease of INR in a patient with FHF prior to an invasive procedure was safe and efficacious, and clinicians should be aware of the risk of thrombosis.
Recombinant activated factor VII in liver patients: a retrospective cohort study from Australia and New Zealand
TLDR
Clinical response to rFVIIa in OLT patients and other surgery patients was associated with a significantly lower mortality compared to nonresponders, and there was no relationship between mortality and bleeding response in patients with UGIB.
Activated recombinant factor VII in orthotopic liver transplantation.
Recombinant FVIIa in children with liver disease.
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References

SHOWING 1-10 OF 27 REFERENCES
Safety and efficacy of recombinant factor VIIa in patients with liver disease undergoing laparoscopic liver biopsy.
TLDR
The results of this study suggest that treatment with rFVIIa may offer benefit for patients with liver disease undergoing laparoscopic biopsy.
The treatment of bleeding in hemophilic patients with inhibitors with recombinant factor VIIa.
TLDR
Recombinant factor VIIa is considered a useful, safe, and effective treatment for bleeding in patients with anti-factor VIII (FVIII) and anti-Factor IX (FIX) inhibitors, however, the optimal dose for various clinical situations has yet to be established and requires further investigation.
REDUCED TRANSFUSION REQUIREMENTS BY RECOMBINANT FACTOR VIIa IN ORTHOTOPIC LIVER TRANSPLANTATION: A Pilot Study
TLDR
A single dose of 80 &mgr;g/kg rF VIIa significantly reduced transfusion requirements during OLT, and further study is needed to establish the optimally effective and safe dose of rFVIIa in orthotopic liver transplantation.
Coagulopathy of liver disease
TLDR
Therapy with prothrombin complex concentrates, 1-deamino-8-D-arginine vasopressin and antithrombin III concentrates for the management of coagulopathy caused by liver disease can be hazardous and the use of these products is considered investigational at the present time.
Recombinant factor VIIa improves clot formation but not fibrolytic potential in patients with cirrhosis and during liver transplantation
TLDR
This study shows no evidence for an antifibrinolytic effect of rFVIIa in cirrhotic patients or in patients undergoing OLT.
Recombinant activated factor VII as a universal haemostatic agent.
  • U. Hedner
  • Medicine, Biology
    Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
  • 1998
TLDR
Recombinant FVIIa (rFVIIa), enzymatically active only after complex formation with TF exposed following tissue damage, has been demonstrated to induce haemostasis in haemophilia patients with life- and limb-threatening bleedings with an efficacy rate of 76-84% in patients having failed on other treatment.
Clinical experience with recombinant factor VIIa.
TLDR
Treatment with recombinant factor VIIa has been evaluated in 518 serious bleeding episodes and the response was considered either excellent or effective in 62% of muscle, 80% of ear, nose and throat, 88% of central nervous system, 76% of joint, and 75% of internal or retroperitoneal bleeding episodes.
Safety and initial clinical efficacy of three dose levels of recombinant activated factor VII (rFVIIa): results of a Phase I study
  • B. Macik, C. Lindley, H. Roberts
  • Medicine, Biology
    Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
  • 1993
TLDR
RFVIIa demonstrated positive initial safety and efficacy for treatment of haemorrhagic episodes in severe haemophiliacs with and without antibodies to factor VIII and IX.
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