The results of this experimental study do not come as a surprise, given the tissue factor dependent mechanism of action of rFVIIa. Fresh anastomoses should, in theory at least, be at risk of occlusion in the presence of high concentrations of rFVIIa and this was what the authors observed. It is always difficult to extrapolate animal results to the clinical context but several case reports have been published suggesting that similar adverse events may occur in humans.

– Jean-François Hardy