1. ¹Department of Pathology, Transfusion Medicine Division, Medical University of South Carolina, Stanford University, Stanford, CA, USA
2. ²Hematopathology Division, Medical University of South Carolina, Stanford University, Stanford, CA, USA
3. ³Department of Pediatrics, Division of Neonatology, Medical University of South Carolina, SC, USA

Correspondence: Magali J. Fontaine, MD, PhD, Assistant Professor of Pathology, Associate Director of Transfusion Service, Transfusion Service, 300 Pasteur Drive M/C 5626 Stanford, CA 94305-5626, USA. Tel.: (650) 736-4250; Fax: (650) 723-9178; E-mail: magalif@stanford.edu

Abstract

The risk of hemorrhage in infants with severe coagulopathies unresponsive to fresh frozen plasma (FFP) infusions may preclude therapeutic invasive interventional procedures. We describe the successful use of recombinant factor VIIa (rFVIIa) in two such infants, the first with cirrhosis requiring paracentesis and the second with necrotizing enterocolitis requiring laparotomy. This report reviews the current concepts on the mechanism of action of the drug rFVIIa and considers its expanded use in infants unresponsive to FFP replacement.