Recombinant human coagulation factor VIIa in Jehovah's witness patients undergoing liver transplantation

Nicolas Jabbour*, Singh Gagandeep, Peilin Alice Cheng, Brendan Boland, Rod Mateo, Yuri Genyk, Rick Selby, Gary Zeger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Indisputably, liver transplantation is among the most technically challenging operations in current practice and is compounded by significant coagulopathy and portal hypertension. Recombinant human coagulation factor VIIa (rFVIIa) is a new product that was initially described to treat bleeding in hemophilia patients. We present in this paper 10 liver transplants in Jehovah's Witness patients using this novel product at University of Southern California-University Hospital. The subject population included nine males and one female with an average age of 50 years. Six patients underwent cadaveric and four live donor liver transplantation. Surgeries were conducted following our established protocol for transfusion-free liver transplantation, which includes preoperative blood augmentation, intraoperative blood salvage, acute normovolemic hemodilution, and postoperative blood conservation. Factor rFVIIa was used at a dose of 80 μg/kg intravenously just prior to the incision in all patients, and a second intraoperative dose was used in 3 patients. All living donor liver transplantation (LDLT) recipients did well and were discharged uneventfully with normal liver functions. Two of the six cadaveric recipients died. One patient died intraoperatively from acute primary graft nonfunction, and the other died 38 hours postoperatively from severe anemia. This report suggests factor rFVIIa might have a much broader application in surgery in the control of bleeding associated with coagulopathy.

Original languageEnglish
Pages (from-to)175-179
Number of pages5
JournalAmerican Surgeon
Issue number2
StatePublished - 2005


Dive into the research topics of 'Recombinant human coagulation factor VIIa in Jehovah's witness patients undergoing liver transplantation'. Together they form a unique fingerprint.

Cite this