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Semin Thromb Hemost
DOI: 10.1055/a-2779-4843
Original Article

Use of Plasma-Derived FVII Concentrate in Surgical Patients with Factor VII Deficiency: A Case Series

Authors

  • Paolo Conca   *

    1   Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy

  • Ernesto Cimino   *

    1   Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy

  • Anna Guida

    2   Centro per le Malattie Emorragiche Congenite e Malattie Trombotiche, AOU S. Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy

  • Rosa Albisinni

    3   UOC CCH Generale e dei Trapianti, AORN DEI COLLI OSP, Monaldi, Naples, Italy

  • Tommaso Marrazzo

    4   UOC Medicina Interna e dei Trapianti, AORN DEI COLLI OSP, Monaldi, Naples, Italy

  • Raffaele Russo

    1   Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy

  • Lucia Agrelli

    2   Centro per le Malattie Emorragiche Congenite e Malattie Trombotiche, AOU S. Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy

  • Umberto Mazzarelli

    2   Centro per le Malattie Emorragiche Congenite e Malattie Trombotiche, AOU S. Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy

  • Matteo Di Minno

    1   Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy

  • Antonella Tufano

    1   Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
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Abstract

Congenital factor VII (FVII) deficiency is the most common rare hemorrhagic disorder. Acquired FVII deficiency can be isolated or associated with other low coagulation factor levels. FVII levels do not accurately predict a patient's bleeding risk. In the case of surgery, the perioperative management needs to be evaluated on a case-by-case basis, considering the patient's bleeding history and the type of surgery. We present 12 patients with congenital or acquired FVII deficiency and describe the perioperative management with plasma-derived nonactivated FVII (pd-FVII) concentrate. Patients with factor VII deficiency treated with pd-FVII for perioperative hemostasis, between April 2022 and May 2025. We report thirteen procedures in 12 patients (11 males and 1 female; age range: 15–78 years). Two patients were affected by acquired deficiency, and 10 patients presented congenital deficiency. Perioperative prophylaxis with pd-FVII was performed at doses ranging from 20 to 40 IU/kg/dose. Total pd-FVII consumption ranged between 20 and 320 IU/kg. During and after surgery, there were no major bleeding or thrombotic events. In the postoperative period, only one patient presented with hematuria.

Keywords

factor concentrates - inherited coagulation disorders - prophylaxis - surgery - bleeding disorder treatment - laboratory hemostasis diagnostics

* These authors contributed equally to this article.




Publication History

Received: 23 July 2025

Accepted: 26 December 2025

Article published online:
09 January 2026

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