RESUMEN
Recombinant activated factor VII (rFVIIa, NovoSeven, Novo Nordisk A/S, Denmark) is a treatment used to prevent and arrest intra- and postoperative bleeds in patients with haemophilia A or B complicated by circulating anticoagulants (inhibitors of FVIII and FIX). Patients who qualify for liver transplantation may have varying degrees of coagulation impairment, which may adversely impact elective anaesthetic and surgical procedures and elevate the risk of intraoperative bleeds, which require massive blood transfusions and worsen prognosis. Recently, reports have been published on the use of rFVIIa prior to surgical procedures, which are likely to cause severe blood loss as well as for so-called emergency therapy of coagulation disorders during liver transplantation.
Asunto(s)
Factor VIIa/uso terapéutico , Trasplante de Hígado/métodos , Adolescente , Adulto , Trastornos de la Coagulación Sanguínea/tratamiento farmacológico , Hepatitis C Crónica/sangre , Hepatitis C Crónica/cirugía , Degeneración Hepatolenticular/sangre , Degeneración Hepatolenticular/cirugía , Humanos , Fallo Hepático/sangre , Fallo Hepático/cirugía , Masculino , Persona de Mediana Edad , Hemorragia Posoperatoria/prevención & control , Proteínas Recombinantes/uso terapéuticoRESUMEN
Recombinant activated factor VII (rFVIIa, NovoSeven, Novo Nordisk A/S, Denmark) is a treatment used to prevent and arrest intra- and postoperative bleeding in patients with haemophilia A or B complicated by circulating anticoagulants (inhibitors of FVIII and FIX) and in patients without haemophilia who spontaneously develop inhibitors of FVIII, i.e. in acquired haemophilia. Patients who qualify for liver transplantation due to liver dysfunction may have varying degrees of coagulation impairment and thus carry an elevated risk of massive bleeding and have worse prognosis. The authors administered recombinant activated factor VII to two patients with coagulation abnormalities in the course of Wilson's disease during liver transplantation.