Recombinant factor VIIa: Unregulated continuous use in patients with bleeding and coagulopathy does not alter mortality and outcome

S. Ganguly, K. Spengel, L. L. Tilzer, B. O'Neal, S. Q. Simpson

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Recombinant factor VIIa (rFVIIa) is used in patients with hemophilia who had developed inhibitors. A hemostatic effect has been demonstrated following the administration of rFVIIa in patients after trauma and bleeding. Currently, there is no widely accepted guideline for off-label rFVIIa usage in bleeding patients. We planned to review the rFVIIa utilization practice in our institution and develop policies and guidelines for future rFVIIa use. We acquired the medical records of 55 patients who received rFVIIa at our institution during 2003-2004. Patient charts were reviewed regarding their rFVIIa administration and indications, dose and frequency, cost, pre-rFVIIa blood component usage, utilization of hematology services and outcome were analyzed. Underlying liver disease with coagulopathy was the commonest (47%) indication for rFVIIa use. Recombinant FVIIa was successful (69%) in correcting laboratory parameters of coagulopathy, but did not alter outcome. Twenty-six of the 55 patients (47%) died during the same admission from their underlying diseases. Apart from two trauma patients, no one died from bleeding. We conclude that unregulated continuous administration of rFVIIa in bleeding/coagulopathic patients did not alter outcome. Closer monitoring of rFVIIa usage, including hematology consultation and enforcement of pre-rFVIIa blood component usage would optimize cost-effectiveness.

Original languageEnglish (US)
Pages (from-to)309-312
Number of pages4
JournalClinical and Laboratory Haematology
Volume28
Issue number5
DOIs
StatePublished - Oct 2006

Keywords

  • Coagulopathy
  • Factor VIII inhibitor
  • Hemorrhage
  • Recombinant factor VIIa

ASJC Scopus subject areas

  • Hematology

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