This is a report on 4 patients who underwent liver transplant surgery in whom coagulopathy was corrected with treatment with rFVIIa, but 2 patients subsequently suffered with thrombotic complications. One patient suffered myocardial ischemia which recovered completely and she had an underlying diagnosis of paroxysmal nocturnal hemoglobinuria, which is a prethrombotic condition. Another patient developed portal vein thrombosis one day postoperatively. Although reported cases of thromboembolic complications following the use of rFVIIa remain very few, it is recommended that rFVIIa is used to correct coagulopathy when other standard treatment modalities fail.

– Maadh Aldouri