Preemptive administration of recombinant factor VII (rVIIa) in patients transplanted due to fulminant Wilson's disease.

Background: Fulminant liver failure (FLF) is a severe clinical condition usually accompanied by a coagulopathy, which is one of the key selection criteria for liver transplantation. Prolongation of prothrombin time can vary between etiologies of FHF, being one of the worst in fulminant presentation of Wilson's disease. Although INR value is not predictive for hemorrhage, it is commonly accepted that INR >1.

Recombinant factor VII (activated) for haemorrhagic complications of severe sepsis treated with recombinant protein C (activated).

We report on 2 cases of severe sepsis treated with drotrecogin-alpha (Xigris, Eli Lilly), where massive perioperative haemorrhage required administration of recombinant factor VIIa. The first patient developed severe sepsis after surgery (laparoscopic cholecystectomy, laparotomy due to peritonitis). After 18 h of treatment with Xigris, the patient developed massive, refractory gastrointestinal and abdominal bleeding.

Biliary complications following adult liver transplantation with routine use of external biliary drainage.

Objectives: Biliary complications are still common and often related to the use of biliary drains in liver transplant setting. We analyzed the incidence, treatment and outcome of biliary complications following adult orthotopic liver transplantation (OLTx) performed between February 2002 and October 2004.

Methods: Overall there were 46 OLTx performed in 44 patients.

Early results of a new liver transplant program in Szczecin, Poland.

New liver transplant programs have usually been associated with a significant learning curve. This learning curve, however, can be minimized or avoided if certain conditions are met. In this paper we describe the establishment of a new liver transplant program in Szczecin, Poland and present its early results.