What is the simplified explanation of recombinant Factor VIIa’s hemostatic effect?
  Factor X is activated by Factor VIIa/TF to produce platelet activation and cofactor activation. At high doses, Factor VIIa binds weakly to the surface of activated platelets, and on the platelet surface it can convert Factor X to Factor Xa. This Factor Xa remains associated with the platelet surface, where it can bind to Factor Va and generate sufficient thrombin for hemostasis. Because high-dose recombinant Factor VIIa only activates Factor X on activated platelets and not on resting platelets, the reaction is localized to the site of injury.
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