LiverOperative procedure/postoperative careActivated Recombinant Factor VII in Orthotopic Liver Transplantation
Section snippets
Materials and Methods
From November of 2003 to July of 2004, 20 of the 25 patients who underwent OLT met inclusion criteria and were enrolled in our study. All patients were informed and written informed consent was obtained. Inclusion criteria were: Hb > 8 mg/dL, INR > 1,5, Fibrinogen (FBG)> 100 mg/dL. Patients were randomized into two groups according to a double blind scheme: a group rFVIIa (10 patients) and a control group (CTR) (10 patients). The rFVIIa group was administered as a single bolus of 40 μg/Kg
Results
OLT was performed successfully in all patients. Average surgery time was 6 hours and 48 min (SD 56 minutes) in rFVIIa group and 7 hours and 12 minutes (SD 48 minutes) in the CTR group (P = NS). All patients postoperatively were admitted to a dedicated post transplant intensive care unit. Average length of stay in the ICU was 4.8 days (SD 1.3) in rFVIIa group and 5,2 days (SD 1,2) in the CTR group (P = NS). No primary non-function or deaths occurred in either group. One delayed non-function
Discussion
The efficacy of rFVIIa to treat bleeding among patients with congenital or acquired hemophilia is known.6 A previous clinical trial showed similar results in the treatment of bleeding among patients with clotting failure due to cirrhosis. Bernstein corrected PT within 12 hours using three different doses of rFVIIa (5, 20 and 80 μg/Kg) in nonbleeding cirrhotic patients.7 Jeffers, co-author of Bernstein, repeated the study during laparoscopic hepatic biopsy administering four different doses (5,
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