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The use of recombinant factor VIIa in children with inherited platelet function disorders.

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 […]

The interaction between platelets and factor VII/VIIa.

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

New approach to management of life-threatening bleeding in a Jehovah’s Witness.

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 […]

Acquired factor VII deficiency in hematopoietic stem cell transplant recipients.

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 […]

Use of recombinant factor VIIa in hereditary bleeding disorders.

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 […]