Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

28 September 2010

Preemptive administration of recombinant factor VII (rVIIa) in patients transplanted due to fulminant Wilson’s disease

Maria M. Czuprynska, Marta Wawrzynowicz-Syczewska, Lidia Jureczko, Janina Andrzejewska, Konrad Jarosz, Janusz Trzebicki, Marek Pacholczyk, Andrzej Chmura, Maciej Wojcicki

Ann Transplant 2010; 15(3): 7-10 :: ID: 881163


Background: Fulminant liver failure (FLF) is a severe clinical condition usually accompanied by a coagulopathy, which is one of the key selection criteria for liver transplantation. Prolongation of prothrombin time can vary between etiologies of FHF, being one of the worst in fulminant presentation of Wilson’s disease. Although INR value is not predictive for hemorrhage, it is commonly accepted that INR >1.9 carries a substantial risk of intraoperative bleeding. We tested the hypothesis that preemptive administration of recombinant factor VII (rFVIIa) is a safe and efficacious approach allowing performance of urgent liver transplantation without significant bleeding and thrombotic complications.
Material/Methods: In 14 analyzed cases of fulminant Wilson’s disease subjected for orthotopic liver transplantation (OLT), a single bolus of rFVIIa 10 minutes before skin incision was given routinely in a median dose of 55.9 microg/kg.
Results: Median value of INR dropped from 3.1 to 1.2 30 minutes after rFVIIa administration. Transfusion requirements in those cases did not differ from standard transfusion requirements of PRBCs observed in elective OLTx in our center (6 units v. 5, respectively). Recurrent bleeding was noted in 1 patient with the rupture of aorta. One-year survival rate in the studied group was 85.7%. Thrombotic complications were noted in none of the patients.
Conclusions: We conclude that preemptive use of rFVIIa allows performance of a broad surgical procedure without hemorrhagic complications and without increased risk of thromboembolic events in patients with severe coagulopathy.

Keywords: Liver Transplantation, fulminant hepatic failure, Wilson’s disease, coagulation disorders, recombinant factor VII

Add Comment 0 Comments

In Press

06 Feb 2024 : Case report  

Successful Sequential Liver and Isolated Intestine Transplantation for Mitochondrial Neurogastrointestinal ...

Ann Transplant In Press; DOI: 10.12659/AOT.941881  

12 Feb 2024 : Original article  

No Prognostic Impact of Graft-to-Recipient Weight Ratio on Hepatocellular Carcinoma Recurrence Following Li...

Ann Transplant In Press; DOI: 10.12659/AOT.942767  

21 Feb 2024 : Original article  

Use of LCP-Tacrolimus (LCPT) in Kidney Transplantation: A Delphi Consensus Survey of Expert Clinicians

Ann Transplant In Press; DOI: 10.12659/AOT.943498  

Most Viewed Current Articles

05 Apr 2022 : Original article  

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

12 Jan 2022 : Original article  

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

22 Nov 2022 : Original article  

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358