Activated recombinant factor VII (rFVIIa)

Recombinant activated factor VII (rFVIIa) is a haemostatic agent, which was originally developed for the treatment of haemophilia patients with inhibitors against factor FVIII or FIX. The efficacy of rFVIIa in preventing or stopping life-threatening bleeding for these patients has been demonstrated in several studies. Since the first report about the successful use of rFVIIa in a bleeding soldier in 1999, rFVIIa has gained popularity as an adjunct for the treatment of coagulopathy in a wide array of clinical conditions with serious or life-threatening bleeding. The number of case reports and case series documenting the successful use of rFVIIa as last resort to terminate uncontrollable bleeding has steadily grown. Conflicting results have been reported from various studies. Considering the lack of data and potential publication bias associated with case reports, this review summarises the clinical evidence of the efficacy and safety of rFVIIa in the perioperative period.