Recombinant factor VIIa improves clot formation but not fibrolytic potential in patients with cirrhosis and during liver transplantation.
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Etiology of bleeding in cirrhotic patients during surgery is multifactorial, and its management includes several measures such as replacement of coagulation factors and platelets as well as the use of antifibrinolytic agents. Recombinant factor VIIa has been shown to normalize prothrombin time in patients with liver disease and to reduce transfusion requirement during OLT. In this study, 6 patients undergoing OLT received rFVIIa at beginning of surgery vs. 6 control. There was no significant difference between clot lysis time and thrombin-activatable fibrinolysis inhibitor in the 2 groups, but coagulation time was significantly reduced in cirrhotic and control plasma after adding rFVIIa.
– M. Aldouri.