Recombinant factor VIIa used to control massive haemorrhage during renal transplantation surgery; vascular graft remained patent.

There is a growing body of evidence to support the use of rFVIIa in cases of excessive bleeding outside its approved use in haemophilia with inhibitors. We now report its use for a paediatric renal transplant case in which its use was both life saving and did not threaten the vascular grafts. To our knowledge this represents the first reported case of rFVIIa used in the setting of renal transplantation. It is reassuring that despite use of a high dose of rFVIIa (>135 mcg/kg; recommended standard dose is 90 mcg/kg) there was no evidence of anastomotic thrombosis.