Successful use of recombinant factor Viia in traumatic liver injury--a case report.

The paper describe the use of rFVIIa in the management of massive bleeding in a patient with polytrauma involving liver injury. An 18-year-old girl with severe polytrauma sustained during a bus-car collision. She had multiple musculoskeletal injuries, severe concussion of the liver with amputation of the left liver lobe, disruption of the left hepatic vein from the inferior vena cava, and impaired hemostasis. Acute bleeding (> 5 L) was not improved by conservative methods and a single dose of rFVlla 90 pg/kg was administered. Infusion of rFVlla resulted in an immediate clinical effect with rapid improvements in blood laboratory measurements and coagulation parameters. rFVIIa should be considered as an adjunctive treatment for the control of hemorrhage in severely injured patients with uncontrolled bleeding and impaired hemostasis.