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M. Margaret Knudson, MD

Arch Surg. 2008;143(3):304.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In 1999, the US Food and Drug Administration approved the use of rFVIIa for the treatment of bleeding episodes in patients with the inherited coagulation disorder hemophilia A or B and inhibitors to factor VIII or IX. Increasingly, however, this product is being used by surgeons to treat patients with acquired coagulopathy, particularly during surgical procedures in which large blood loss is anticipated, such as cardiac, vascular, and liver transplantation surgery. As experience continues to accumulate and the literature documents its effectiveness, this drug is often administered prophylactically to limit transfusion requirements. However, as outlined in the meta-analysis by Ranucci et al, there is considerable variation across studies in the dose used and in the timing of administration. Because the effectiveness of rFVIIa in promoting clot formation may be affected by other factors, such as the platelet count, the fibrinogen level, and the pH at the . . . [Full Text of this Article]

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