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British Journal of Anaesthesia 2005 94(5):553-555; doi:10.1093/bja/aei103
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org

Editorial

Is recombinant FVIIa the magic bullet in the treatment of major bleeding?

D. R. Spahn* and M. A. Tucci

Department of Anaesthesiology, University Hospital Lausanne (CHUV), CH-1011 Lausanne, Switzerland

M. Makris

Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK

* Corresponding author. E-mail: donat.spahn@chuv.hospvd.ch

The first 150 words of the full text of this article appear below.

Recombinant activated factor VII (rFVIIa) (NovoSeven®, Novo Nordisk, Bagsvaerd, Denmark) was originally developed to treat bleeding in haemophiliacs with antibodies to factor VIII and IX.1 2 At present, rFVIIa is approved in the European Union for this indication and also for the treatment of bleeding in FVII deficiency and Glanzmann thrombasthenia refractory to platelet transfusions.

FVIIa normally circulates in minute quantities and binds to tissue factor (TF) expressed by the damaged vascular bed. The TF-FVIIa complex on TF-bearing cells activates FIX and FX. FXa remains in close proximity to TF-bearing cells and activates FV. The FXa–FVa complex on TF-bearing cells rapidly converts small amounts of prothrombin into thrombin.1 3 This initial small amount of thrombin activates platelets, FVIII, FV and FXI. On the surface of activated platelets, FVIIIa and FIXa gather to activate large quantities of FX which finally (in conjunction with FVa) will result in the large thrombin burst which enables . . . [Full Text of this Article]

Declaration of interest


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