Table 3 Case reports on the treatment of severe bleeding with rFVIIa in patients undergoing abdominal surgery without known pre-existing coagulopathy

White et al. [19] (1999)

1) 22 years, female, Crohn disease with colon resection due to bleeding

1) Persistent postoperative bleeding in spite of tranexamic acid and desmopressin

1) 2 × 90 μg/kg

1) Cessation

2) 62 years, male, T-cell lymphoma with colon resection due to bleeding

2) Persistent bleeding in spite of relaparotomy

2) 2 × 90 μg/kg

2) Cessation, death due to multiple organ failure

Vlot et al. [27] (2000)

59 years, male, three laparotomies due to bleeding duodenal ulcer

Persistent bleeding in spite of surgical measures and tranexamic acid; rFVIIa in combination with octreotide

90 μg/kg every 2 hours over the span of 21 hours

Reduction

Chuansumrit et al. [28] (2002)

Premature infant, explorative laparotomy due to extraperitoneal hematoma of abdominal wall

Persistent bleeding in spite of FFP, cryoprecipitate and platelets

2 × 40 μg/kg

Cessation

Svartholm et al. [16] (2002)

50 years, female, pancreas necrosis and pseudocyst, pancreas resection, subtotal gastrectomy, splenectomy

Persistent bleeding from pancreas in spite of FFP, PCC, desmopressin, antithrombin, fibrinogen, tranexamic acid, and aprotinin

2 × 120 μg/kg (second dose after 5 hours)

Cessation after second dose

Danilos et al. [30] (2003)

45 years, female, resection of two big extraperitoneal sarcomas in the inguinal region

Life-threatening intraperitoneal bleeding with multiple bleeding sites in emergency laparotomy

80 μg/kg

Cessation 10 minutes after injection

Holcomb et al. [14] (2003)

45 years, male, necrotizing pancreatitis and explorative laparotomy with debridement of pancreas necrosis

Intraoperative bleeding, hypothermia, acidosis, coagulopathy, septic shock; massive transfusions during and after operation

120 μg/kg

Cessation

Schuster et al. [32] (2003)

55 years, male, hemorrhagic pancreatitis, compartment syndrome, excision of hematoma

Persistent bleeding

3 × 100 μg/kg

Cessation

Michalska-Krzanowska et al. [22] (2003)

1) 33 years, male, resection of the kidney

1) Persistent bleeding in spite of surgery/packing

1) 17 μg/kg

1) Cessation

2) 56 years, male, prostatectomy

2) Massive, multifocal bleeding

2) 12 μg/kg

2) Cessation

Gielen-Wijffels et al. [21] (2004)

51 years, male, renal transplantation

Intra-abdominal bleeding after surgery, persistent hemodynamic instability in spite of reoperation

70 μg/kg

Stabilization of hemodynamics and hemoglobin value

Romero-Castro et al. [33] (2004)

53 years, male, endoscopic sphincterectomy

Persistent bleeding from the papilla with need for second endoscopy

4.8 mg

Cessation within 12 minutes

Dunkley and Mackie [20] (2003)

15 years, female, renal transplantation

Intraoperative, multiple bleedings, which cannot be controlled by conventional measures

135 μg/kg

Immediate reduction

Wordliczek et al. [17] (2003)

43 years, male, splenectomy and necrectomy in patient with acute pancreatitis

Persistent bleeding from drains

40 μg/kg; after 4 hours: 80 μg/kg

Reduction of bleedings from drains

Girisch et al. [31] (2004)

Premature infant, resection of sacrococcygeal teratoma

Persistent bleeding requiring emergency laparatomy

3 dosages, 150 μg/kg in total

Cessation

Sander et al. [23] (2004)

65 years, male, renal transplantation, thrombectomy

Massive intraoperative bleeding

30 μg/kg

Cessation

Raux et al. [24] (2005)

56 years, male, aortobifemoral bypass revision, pretreatment with aspirin and clopidogrel

Persistent bleeding in spite of FFP, platelets, fibrinogen, aprotinin as well as operations

90 μg/kg; after 2 hours: 45 μg/kg

Cessation; recurrence controlled with rFVIIa