Original ArticlesEffects of recombinant activated factor VII on coagulation measured by thromboelastography in liver transplantationHendriks, H. G. D.; Meijer, K.; de Wolf, J. Th. M.; Porte, R. J.; Klompmaker, I. J.; Lip, H.; Slooff, M. J. H.; van der Meer, J.Author Information H. G. D. Hendriks and H. Lip are with the Department of Anesthesiology, K. Meijer and J. van der Meer are with the Division of Hemostasis, Thrombosis and Rheology, J. Th. M. de Wolf is with the Department of Hematology, R. J. Porte and M. J. H. Slooff are with the Department of Hepatobiliary Surgery and Liver Transplantation, and I. J. Klompmaker is with the Department of Hepato-Gastroenterology, University Hospital, Groningen, The Netherlands. (Received 22 October 2001; revised 21 January 2002; accepted 24 January 2002) Address correspondence to H. G. D. Hendriks, M.D., Groningen University Hospital, Department of Anaesthesiology, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. Tel: (+31) 50 361 36 37; eax: (+31) 50 361 37 63; e-mail: [email protected] Blood Coagulation & Fibrinolysis: June 2002 - Volume 13 - Issue 4 - p 309-313 Buy Abstract Besides the conventional laboratory tests, thromboelastography (TEG) is used to monitor hemostasis during liver transplantation. A previous pilot study suggested a beneficial effect of recombinant activated factor VII (rFVIIa) on transfusion requirements in liver transplantation. In the present study, we assess the effects of rFVIIa on coagulation variables and TEG. In six study patients, the prothrombin time (PT), the activated partial thromboplastin time (aPTT) and TEG variables [reaction time (r), kinetic time (k), or clot formation time, α angle (α), and maximal amplitude (MA)] were recorded before and after the administration of a bolus of 80 μg/kg rFVIIa. These patients were compared with six controls who did not receive rFVIIa. In contrast with the control group, a significant shortening of PT (P = 0.028) and aPTT (P = 0.028), r (P = 0.046) and k (P = 0.043) values, and a significant incline of the α angle (P = 0.028) were noticed after injection of rFVIIa, whereas MA increased not significantly (P = 0.075). rFVIIa rapidly improved coagulation variables in liver transplant patients including PT and aPTT. Of the TEG variables, r, k and α angle significantly improved, and MA showed a trend to increase. These data suggest that rFVIIa not only influences the speed of clot formation, but also the physical properties of the clot, which cannot be detected by routine coagulation tests. © 2002 Lippincott Williams & Wilkins, Inc.