This is an interesting report on a small series of children with inherited platelet dysfunction treated with rFVIIa for acute bleeding or preoperatively. Response seemed to correlate with type of underlying condition, severity of bleeding and delay in presentation. In this series rFVIIa had variable efficacy in securing hemostasis. There was no difference in requirement […]
This is a clearly written article detailing the mechanism of action of rFVIIa and its interaction with tissue factor and platelets leading to its hemostatic effect in hemophilia patients with inhibitors and those with platelet disorders. – Maadh Aldouri
This is an overview on the mechanism of action of rFVIIa and its role in hemostasis. rFVIIa directly activates FX, increases thrombin activation on activated platelets, and leads to generation of strong fibrin clot which is more resistant to fibrinolysis. rFVIIa exerts its action by interacting with tissue factor, but this group showed that high […]
Possible role of recombinant activated factor VII (RFVIIa) in the control of hemorrhage associated with massive trauma.
This is a report on the largest series on the use of rFVIIa in treating patients suffering from uncontrolled bleeding as a result of trauma in spite of surgical treatment and blood transfusion. There were 19 patients who received 1-3 doses of rFVIIa, and bleeding was controlled in 15 of them. Transfusion requirement was reduced, […]
A novel hemostatic agent: the potential role of recombinant activated factor VII (RFVIIa) in anesthetic practice.
This is an excellent literature review on the adjuvant use of rFVIIa in treating severe bleeding associated with surgical procedures in non-hemophiliac patients. It gives an overview of the mechanism of action of rFVIIa and its efficacy in patients with hemophilia, platelet dysfunction and liver disease. It also reviews its efficacy in managing bleeding in […]
This is an editorial on an article we commented previously (Gannon et al. Crit Care Med 2002;30:1893-5). The author reviews a number of interesting points on rHuEPO and oxygen therapeutics. He then comments on the role of HBOC-201 (the hemoglobin solution used to resuscitate this patient) in the final demise of the patient, who died […]
Somewhat similar to the letter published by Cothren et al. in the NEJM, this article reports the case of a Jehovah’s witness who bled to a nadir hemoglobin concentration of 3.5 g/dL and was treated with 7 units of a bovine hemoglobin-based oxygen carrier and high-dose erythropoietin. No data are presented on oxygen transport variables, […]
This article helps to focus attention on the risk of TRALI although it doesn’t really describe anything new. One should discuss renouncement of plasma from female multipara donors at least for plasma exchange. – V. Kretschmer
This is an interesting and new case report on the occurrence of acquired factor VII deficiency in eight patients following intensive chemotherapy and/or radiotherapy followed by hematopoietic stem cell transplantation (SCT), associated with serious and sometimes fatal hemorrhagic complications with poor response to transfusion of blood components. Tests for antibodies against FVII were negative. It […]
Successful use of recombinant factor VIIa for hemostasis during total knee replacement in a severe hemophiliac with high-titer factor VIII inhibitor.
This is another case report of a successful use of rFVIIa in covering knee replacement surgery in a patient with severe hemophilia A and high-titer inhibitor. rFVIIa was given at a dose of 85 u/kg at 2-hourly interval initially, increasing the interval between infusions every 48 hours. Effective hemostasis was achieved. The authors recommend administering […]
This is another excellent review of the mechanism of action, indications, and various doses of rFVIIa (Novoseven) in hereditary bleeding disorders. Its main use has been in patients with factor VIII or IX deficiency with inhibitors, where rFVIIa can by-pass factors VIII or IX, interacts with tissue factor and generates thrombin in addition to activating […]
New products for managing inhibitors to coagulation factors: a focus on recombinant factor VIIa concentrate.
A very good review of inhibitors to coagulation factors, in congenital or acquired hemophilia, that covers the incidence, pathogenesis, treatment strategies (including different alternatives to human factors), and induction of immune tolerance. The article contains an algorithm approach for the management of such patients, with emphasis on the use of rFVIIa in managing hemophiliac patients […]