Application of recombinant activated factor VII in the treatment of acute intracranial hemorrhage after liver transplantation

Objective To investigate the effect of recombinant activated factor Ⅶ(rFⅦa) in the treatment of acute intracranial hemorrhage after liver transplantation, and in the prevention of bleeding during craniotomy and postoperative rebleeding. Methods The cases with intracranial hemorrhage after liver transplantation from October 2003 to September 2005 in our hospital were analyzed retrospectively. rFⅦa 50~60 μg/kg was administered less than 4 h after intracranial hemorrhage, or 50~60 μg/kg was administered during second craniotomy for rebleeding. Results In the 503 cases undergoing liver transplantation, 10 had intracranial bleeding, among them rFⅦa was administered in 3 cases less than 4 h after intracranial hemorrhage, and combined with early neurosurgical intervention, 2 were cured, 1 died of multi-organ failure; 1 case was treated with ultra-early rFⅦa combined with conservative therapy, and died of multi-organ failure; 3 cases with rFⅦa administration during craniotomy had no postoperative rebleeding, and were cured. Conclusion rFⅦa may be an option for early control of acute intracranial hemorrhage after liver transplantation. Ultra-early rFⅦa administration combined with early neurosurgical intervention and rFⅦa administration during craniotomy should be considered as a therapeutic measure against acute intracranial hemorrhage after liver transplantation.