Recombinant Activated Factor VII as an Adjunct to Packing for Liver Injury with Hepatic Venous Disruption

Abstract

Injuries to the juxtahepatic veins represent a small proportion of all liver injuries but constitute the most challenging and deadly form of hepatic trauma. Recombinant activated factor VII, established as a crucial therapy for enhancing hemostasis in hemophiliacs with inhibitors, has also been used to correct coagulopathy after traumatic injury. We report two children with hepatic venous injury requiring perihepatic packing and recombinant activated factor VII to successfully control hemorrhage.

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References

Mooney

D.P.

Multiple trauma: Liver and spleen injury.

Curr Opin Pediatr 2002; 14: 482–5.

Gross

, Lynch

, Canty

Management of pediatric liver injuries: A 13-year experience at a pediatric trauma center.

J Pediatr Surg 1999; 34: 811–7.

Bond

S.J.

, Eichelberger

M.R.

, Gotschall

C.S.

Nonoperative management of blunt hepatic and splenic injury in children.

Ann Surg 1996; 223: 286–9.

Walt

A.J.

, Levison

M.A.

Hepatic trauma: Juxta-hepatic vena cava injury. In: Champion

H.E.

, Robb

J.V.

, Turnkey

D.D.

, eds. Rob and Smith's Operative Surgery, Trauma Surgery. Boston: Butter-worths, 1992, pp 374–84.

Fabian

T.C.

, Croce

M.A.

, Stanford

G.G.

Factors affecting morbidity following hepatic trauma: a prospective analysis of 482 injuries.

Ann Surg 1991; 213: 540–8.

Buckman

R.F.

, Miraliakbari

, Badellino

M.M.

Juxtahepatic venous injuries: a critical review of reported management strategies.

J Trauma 2000; 48: 978–84.

Martinowitz

, Kenet

, Luboshitz

Recombinant activated factor VII for adjunctive hemorrhage control in trauma.

J Trauma 2001; 51: 431–8.

O'Neill

P.A.

, Bluth

, Gloster

E.S.

Successful use of recombinant activated factor VII for trauma-associated hemorrhage in a patient without preexisting coagulopathy.

J Trauma 2002; 52: 400–5.

Haas

, Innerhofer

, Kuhbacher

Successful reversal of deleterious coagulopathy by recombinant factor VIIa.

Anesth Analg 2005; 100: 54–8.

10.

Vanek

, Straka

, Hrabak

Use of recombinant activated factor VII in cardiac surgery for an effective treatment of severe intractable bleeding.

Jpn Heart J 2004; 45: 855–60.

11.

Zimring

J.C.

Appropriate use of recombinant factor VIIa: An expanding and unanswered question.

Transfusion 2004; 44: 1544–6.

12.

Ghaorashian

, Hunt

B.J.

“Off-License” use of recombinant activated factor VII.

Blood Rev 2004; 18: 245–59.

13.

Hedner

, Erhardtsen

Potential role for rFVIIa in transfusion medicine.

Transfusion 2002; 42: 114–24.

14.

Pachter

H.L.

, Spencer

F.C.

, Hofstetter

S.R.

Significant trends in the management of hepatic trauma.

Ann Surg 1992; 215: 492–502.