The factor VII-platelet interplay: effectiveness of recombinant factor VIIa in the treatment of bleeding in severe thrombocytopathia.

Published

Journal Article (Review)

Recently, high-dose factor VIIa has been used to correct bleeding in patients with various thrombocytopathias including Glanzmann's thrombasthenia, Bernard-Soulier syndrome, and uremia. High-dose factor VIIa is postulated to act on platelets in the absence of tissue factor to activate factors IX and X and thus enhance thrombin generation. This enhanced thrombin generation might help provide hemostasis in patients with thrombocytopathias through several mechanisms. Enhanced thrombin generation would provide a strong signal for recruitment of other platelets. Also, enhanced fibrin deposition might provide mechanisms for bypassing the specific defect in thrombocytopathias. Thus, platelets from a patient with Bernard-Soulier syndrome might associate with fibrin by a glycoprotein IIb-IIIa-mediated mechanism. Also, platelets from a patient with Glanzmann's thrombasthenia might associate with fibrin through von Willebrand factor-mediated interactions with glycoprotein Ib-V-IX. Finally, enhanced thrombin generation on platelets would mean that fewer platelets are required for hemostasis.

Full Text

Duke Authors

Cited Authors

  • Monroe, DM; Hoffman, M; Allen, GA; Roberts, HR

Published Date

  • January 2000

Published In

Volume / Issue

  • 26 / 4

Start / End Page

  • 373 - 377

PubMed ID

  • 11092211

Pubmed Central ID

  • 11092211

Electronic International Standard Serial Number (EISSN)

  • 1098-9064

International Standard Serial Number (ISSN)

  • 0094-6176

Digital Object Identifier (DOI)

  • 10.1055/s-2000-8455

Language

  • eng