Case ReportsPerioperative pharmacokinetics of factor VII concentrate during liver surgery in a patient with congenital factor VII deficiency: an individual mathematical modelCharpiat, B.; Laporte, S.; Mismetti, P.; Debize, G.; Ducerf, C.Author Information B. Charpiat is with the Pharmacy Department, G. Debize is with the Hematology Department, and C. Ducerf is with the Surgery and Liver Transplantation Unit, Croix-Rousse Hospital, Hospices Civils de Lyon, France; and S. Laporte and P. Mismetti are with the Thrombosis Research Group, Clinical Pharmacology Unit, University Hospital Saint Etienne, France. (Received 23 November 2001; revised 4 April 2002; accepted 9 April 2002) Address correspondence to Silvy Laporte, Clinical Pharmacology Unit, University Hospital Bellevue, pavillon 5, 42055 Saint-Etienne, France. Tel: (+33) 4 77 12 05 72; fax: (+33) 77 12 78 20; e-mail: [email protected] Blood Coagulation & Fibrinolysis: July 2002 - Volume 13 - Issue 5 - p 457-460 Buy Abstract A patient with congenital factor VII deficiency (baseline activity, 7%) underwent surgery for hepatocellular carcinoma. No literature reference was found concerning the management of this coagulation defect in patients requiring liver surgery. We report one such case, with special reference to the peri-operative management of factor VII replacement therapy and the pharmacokinetic behavior of factor VII. As a result of accidental suprahepatic vein lesion, a bleeding episode occurred. This was associated with an increase in factor VII clearance and volume of distribution values from 1.30 to 3.85 l/h, and from 6.51 to 13.2 l, respectively. After surgery, the patient continued to receive the concentrate every 8 h during the first nine post-operative days. No post-operative bleeding or thrombotic event was observed. The patient was discharged in good condition. © 2002 Lippincott Williams & Wilkins, Inc.