Use of recombinant factor VIIa in pediatric patients with liver failure and severe coagulopathy.
Transplant Proc
; 37(2): 1091-3, 2005 Mar.
Article
em En
| MEDLINE
| ID: mdl-15848632
ABSTRACT
BACKGROUND:
Several reports have suggested a benefit for recombinant Factor VIIa (rFVIIa) in nonhematological conditions, including liver disease and transplantation. However, there are few reports of its use in children with liver failure. Recently, we used rFVIIa in four patients with liver failure and severe coagulopathy with bleeding who demonstrated significant laboratory and clinical improvement following its use with no side effects. PATIENTS ANDMETHODS:
All four patients were hospitalized with liver failure, coagulopathy, and bleeding that was controlled with fresh frozen plasma, platelets, and other therapies, as indicated. Their international normalization ratios (INR) ranged from 1.7 to 5.8 (normal 0.9-1.1). All four patients received rFVIIa for bleeding episodes that were not responding to their usual therapy, for procedures with a high risk of bleeding, or both. The dose of rFVIIa ranged from 0.067 to 0.3 mg/kg. The INR improved to normal or near normal in all four patients. In all cases, bleeding stopped within 10 minutes of receiving the rFVIIa, and there were no complications observed.CONCLUSIONS:
rFVIIa provided significant benefit in these children with liver failure and severe coagulopathy, in terms of clinical and laboratory improvement in their bleeding and coagulation profiles. There were no obvious side effects from the rFVIIa. This drug may be an important tool in the treatment of children with liver failure and more study is needed to define the optimal dosing for children.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transtornos da Coagulação Sanguínea
/
Fator VIIa
/
Falência Hepática
Tipo de estudo:
Etiology_studies
Limite:
Child
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Transplant Proc
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Canadá