, Volume 31, Issue 2, pp 315-316
Date: 09 Dec 2004

Recombinant FVII in orthotopic liver transplantation (OLT): a preliminary single centre experience

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Sir: As recently assessed by Key [1], the decision on when and where to use rFVIIa for patients with uncontrolled bleeding or in clinical settings in which massive bleeding could be a risk, continues to be a matter of discussion. It seems questions greatly exceed definite answers. In cirrhotic patients, intraoperative blood loss could become critical during major surgery and particularly during orthotopic liver transplantation (OLT): massive blood loss and large transfusion requirements are correlated with increased morbidity and mortality [2]. Innovative preservation solutions and refinements in surgical and anaesthetic techniques have reduced blood losses and transfusion needs during surgery. In this setting, a critical role has been played by the appropriate supplementation of blood products, by the use of antifibrinolytic drugs [3] and, in cases of excessive heparinisation during organ harvesting, by the judicious use of protamine [2]. Recently, the use of recombinant factor VIIa (