{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T13:48:04Z","timestamp":1780667284443,"version":"3.54.1"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients with severe Factor XI deficiency face unique challenges during urological procedures due to an elevated risk of bleeding, balanced against the use of tranexamic acid (TXA), which may form blood clots. Given the limitations associated with plasma\u2010based treatment, there have been reports of successful and safe off\u2010label use of recombinant activated Factor VII (rFVIIa) in combination with TXA in general surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Report our experience with this approach in urological surgeries involving tissues with heightened fibrinolytic activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective case series analysed seven patients with severe FXI deficiency who underwent seven urological procedures. Five patients were classified as bleeders, and two developed antibodies to FXI following prior exposure to plasma. The use of off\u2010label rFVIIa was approved by our institutional authorities. Patients received TXA 1 g four times daily for 7\u201310 days, and a single dose of 10\u201315 mcg\/kg of rFVIIa at the end of surgery (based on previous thrombin generation studies). Patients were connected to a continuous irrigation system postoperatively and monitored for urinary bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All procedures were performed without significant bleeding complications, except for one patient who remained on aspirin therapy and experienced manageable bleeding. None of the patients required discontinuation of TXA due to blood clots, nor did they require blood transfusions or additional doses of rFVIIa. No thrombotic complications were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combination of low\u2010dose rFVIIa with TXA is a feasible and attractive option for patients undergoing urologic procedures. Further implications of this protocol should be implemented in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70052","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T08:16:18Z","timestamp":1745914578000},"page":"1003-1007","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Recombinant Activated Factor VIIa Combined With Tranexamic Acid Control Haemostasis in Patients With Severe Factor XI Deficiency Undergoing Urological Procedures"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7112-7068","authenticated-orcid":false,"given":"Neta","family":"Sternbach","sequence":"first","affiliation":[{"name":"Institute of Hematology Davidoff Cancer Center Rabin Medical Center Petah\u2010Tikva  Petah\u2010Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaron","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"Department of Urology Rabin Medical Center  Petah Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anfisa","family":"Stenevsky","sequence":"additional","affiliation":[{"name":"Institute of Hematology Davidoff Cancer Center Rabin Medical Center Petah\u2010Tikva  Petah\u2010Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Saidian","sequence":"additional","affiliation":[{"name":"Department of Urology Rabin Medical Center  Petah Tikva Israel"},{"name":"Department of Urology Meir Medical Center  Kfar Saba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darawsha Abd","family":"Elhalim","sequence":"additional","affiliation":[{"name":"Department of Urology Rabin Medical Center  Petah Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Baniel","sequence":"additional","affiliation":[{"name":"Department of Urology Rabin Medical Center  Petah Tikva Israel"},{"name":"School of Medicine Faculty of Medical and Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Raanani","sequence":"additional","affiliation":[{"name":"Institute of Hematology Davidoff Cancer Center Rabin Medical Center Petah\u2010Tikva  Petah\u2010Tikva Israel"},{"name":"School of Medicine Faculty of Medical and Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galia","family":"Spectre","sequence":"additional","affiliation":[{"name":"Institute of Hematology Davidoff Cancer Center Rabin Medical Center Petah\u2010Tikva  Petah\u2010Tikva Israel"},{"name":"School of Medicine Faculty of Medical and Health 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