Recombinant Factor VII Activated and Prothrombin Complex Concentrate Use at a Tertiary Academic Medical Center

Abstract

To describe the use of recombinant Factor VII activated (rFVIIa) and three factor prothrombin complex concentrate (PCC3) in the absence of published guidelines, we conducted a single center, retrospective, observational study to evaluate the appropriate of use of rFVIIa and PCC3 therapy based on institution-specific guidelines, which were based on limited published data. Six patients received rFVIIa and 32 received PCC3 during the analysis period. rFVIIa and PCC3 were utilized appropriately in 100 and 91 % of cases, respectively. rFVIIa indications included surgical bleeding (50 %), factor deficiency (33 %), and intracranial hemorrhage (17 %). PCC3 indications included warfarin-related intracranial hemorrhage (47 %), non-warfarin-related intracranial hemorrhage (16 %), surgical bleeding (23 %), trauma (7 %), and other (7 %). PCC3 use was more common than rFVIIa use and was given with FFP and vitamin K for warfarin-related bleeding. The use of clotting factors for life-threatening hemorrhage should be reserved for institution-approved indications based on available literature and expert opinion.