[Recombinant activated factor VII in haemostasis after radical nephrectomy]

Abstract

Introduction: The paper presents important facts in the application of recombinant human factor VIIa (rFVIIa) and in the treatment of renal cell carcer.

Case report: A 69-year old male with infiltrative renal cell carcer underwent radical nephrectomy using Hasagawa's approach. The extirpated tumor was 35 cm in diameter. During surgery, the patient suffered cardiac arrest with 3500 ml blood loss. Twenty-four hours after operation, he lost additional 2100 ml of blood. Despite adequate blood substitution with intensive surgical attempts to treat haemostasis, bleeding did not stop until the application of rFVIIa (300 IU). The patient survived and fully recovered.

Conclusion: To control massive non-surgical bleeding additionally complicated by paraneoplastic syndrome, extensive surgical intervention, haemodilution and massive blood substitution, the application of rFVIIa has proved to be most successful.